Years ago, a physician stopped by my office to talk. He ostensively came by to discuss something I had written that he thought was inaccurate, but mostly he came by to lament the sad state of the medical profession. Back when he began his career, being a doctor was a noble profession he said. When he was young, physician was a calling. Doctors both cared for and cared about their patients. He complained that medicine had turned from a calling into a business. For many doctors, he said caring for patients was just a job.
Nowadays there is a distinct divide between what being a physician meant to the retired physician I spoke with that day and much younger physicians just starting their careers. The following is from the Wall Street Journal:
Dr. Jefferson Vaughan, 63 years old, has worked as a surgeon at Jupiter Medical Center in Jupiter, Fla., for 30 years, and is on call for the emergency room five to seven nights a month. He says he shares the duty with a handful of surgeons around his age, while younger colleagues who practice more specialized surgery are excused.
“All us old guys are taking ER call, and you got guys in their 30s at home every night,” he says. “It’s just a sore spot.”
One older physician summed up the opinions of many older physicians:
“I’m not saying they’re wrong in their desire for a work-life balance,” he says, “but there was a time when the patient came first.”
Many younger physicians are even offended by the idea of physician care being a calling. They see that as little more than an excuse for employers to abuse them. More from WSJ:
There’s a question dividing the medical practice right now: Is being a doctor a job, or a calling?
For decades, the answer was clear. Doctors accepted long hours and punishing schedules, believing it was their duty to sacrifice in the name of patient care. They did it knowing their colleagues prided themselves on doing the same. A newer generation of physicians is questioning that culture, at times to the chagrin of their older peers.
The younger generation of physicians view the idea of physician as a calling as something other than noble. One said:
“It’s code word for being taken advantage of.”
There are other reasons for the gradual shift in attitudes. Decades ago, self-employed doctors were (purportedly) very dedicated to helping their patients. Most doctors at the time were self-employed or partners in small group practices. They set their own priorities and created their own schedules. If you own your own practice, working an extra hour or two per day boosts income substantially. The marginal revenue is almost entirely profit compared to the average gross margin for an 8-hour day. In economics there is also a concept called the cost of leisure. Going home an hour early when you could earn $400 an hour is an hour of leisure that is extremely expensive.
Today about 75% of doctors are employees. Younger doctors are less enthusiastic about being their hospital employer’s indentured servant. Perhaps they see the provision of patient care as their employer’s responsibility, not theirs. Even today in an age when most doctors work for someone else, they still work long hours:
Physicians work an average of 59 hours a week, according to the American Medical Association, and while the profession is well-compensated—the average physician makes $350,000, a recent National Bureau of Economic Research analysis found—it comes with high pressure and emotional strain.
Another factor that irritates younger doctors (and older doctors alike) is the substantial number of administrative tasks that must be done along with seeing patients. A family member who is a physician recently retired. He later asked about the possibility of working part time, say one or two days a week. He dropped the idea when he was told he would still have to attend all the meetings that full-time physician employees had to attend. Nope, the meetings were partly why he wanted to quit in the first place.
Read more at WSJ: Young Doctors Want Work-Life Balance. Older Doctors Say That’s Not the Job.