health policy · narrative medicine · news

Uphill in the snow, both ways

How Millennial physicians will impact disease management (opens in a new tab).

Apparently “Millennial” is the name for my generation, the post-Vietnam, post-modern, post-racism kids who grew up in the financial bubble of the 80s and 90s, watching Sesame Street and texting their little hearts out.  And according to this article, we are single-handedly responsible for the death of medicine.

Buh?

Honestly, this Dr. Sidorov comes across as more than a little curmudgeonly.

They don’t know about bomb shelters, walking to school, tape decks or having to get up to change a TV channel.

Oh, no!  Obviously we are inferior human beings because we don’t duck and cover.

(I will say, though, that this video made me feel very old.  But then, the kids are Canadian…. 🙂 )

I do think the author has a point about this generation being less concerned about rank, which doesn’t jive well with medicine’s rather entrenched hierarchy.  But then the rest of the article discusses how self-absorbed we supposedly are, how we will compromise patient care in the name of work-life balance.

I posted a comment on Kevin MD, but I think this deserves a longer rebuttal.

My main issue is that the article itself makes a poor argument.  I’m not really sure WHY the author thinks we compromise patient care.

Is it because we have a more interdisciplinary approach based on skills rather than the letters after your name?  Isn’t it better to have as many people as possible involved in patient care?  The article doesn’t explain why physicians must do everything, even if there are other people who are better at it.  Is it because physicians will lose money if other professions are let in?  Now who’s being selfish?

Is it because we embrace technology like online scheduling or email?  Again, the article doesn’t convince me that the old system (calling the office)  is better, except that it’s traditional.  Actually, if you have a BlackBerry, you can respond to those basic patient questions — the same stuff you’d call them back about — while you’re at Johnny’s soccer game.  Win-win, guys!

And honestly, what’s wrong with physicians trying to maintain a work-life balance?  Physicians have the highest suicide rate and divorce rate in the country.  Burnout affects doctors and patients.  Plenty of studies and initiatives are trying to address that; this article seems to run the other way by pretending that physician happiness is inversely correlated with patient care.  News flash: medicine is not a zero-sum game.

But the biggest clue that the author doesn’t have a clue:

If a Grand Rounds speaker lacks sufficient eye-candied edutainment in PowerPoint, all the more reason for those young docs to skip out, grab some tofu and surf some YouTube.

Hands up, medical students/residents who like Powerpoint presentations with overloaded graphics and snazzy transitions.

*crickets chirping*

Powerpoint, especially “edutainment” Powerpoint, is the domain of people who have no clue what they are talking about.  I know, because I routinely prepare Powerpoints for a class I’m teaching.  The best lectures and Grand Rounds I’ve ever attended were computer-free. I actually paid attention to the lecturer, because there wasn’t a distracting animated GIF blinking at me.  It’s not the lack of “eye-candy” that turns med students and residents off.  It’s the computer itself.

Sure, there are some people who treat medicine as “just a job.”  These people won’t stay in patient care.  (The author uses the phrase “disease management” which I hate because it eliminates the patient entirely and smacks of spreadsheets on quality control.)  There are jobs out there that have a better work-life balance and higher pay — consulting, administration, government.  People stay in patient care because medicine is more than “just a job.”  But just because we get off on service doesn’t mean we have to ignore advances that can help us serve patients better and more efficiently.

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One thought on “Uphill in the snow, both ways

  1. Thank you for that excellent response. The post at KevinMD was full of generalizations and honestly, arrogance. The prevailing idea seemed to be “the status quo is best because, well, because that’s the way it’s always been!” Maybe a little upset in the hierarchy of medicine could actually be a good thing.

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