番茄社区

There's been blowback in the physician community against some perspectives in a in which certain doctors lambasted a newer generation's push for better work-life balance in medicine.

For generations, doctors put their careers first, prioritizing work over family time and other pursuits. But the article explained how newer doctors believe "medicine's workaholic culture was overdue for a correction."

Many doctors interviewed by 番茄社区 said the times are changing, and that the next generation is right to put themselves first -- especially since healthcare has changed so drastically over the past few decades.

"Older doctors criticizing the work ethic of younger physicians can't ignore the fact that the previous approach of putting your job first caused a lot of untoward consequences -- high suicide rates, high divorce rates," Robert McNamara, MD, chair of emergency medicine at Temple University in Philadelphia, told 番茄社区. "Lecturing the younger docs, saying 'We did it this way,' [isn't right]. We should say, 'Yeah we did it, and we ruined our lives.' To say they should do it the same doesn't make any sense to me."

Lewis Nelson, MD, chair of emergency medicine at Rutgers New Jersey Medical School in Newark, said the "idea that training and practice need to be oppressive, especially given the ongoing changes in the healthcare system, is misguided."

Those changes include the fact that more physicians than ever before are now employees of hospitals and health systems, rather than business owners in control of their own practice. Increased bureaucratic demands, such as fighting health insurance denials, are another, as is diminished reimbursement for services.

"When it's your business and you put in the extra hours, you see the rewards because you own it," McNamara said. "Now when you're working for the company, they're trying to impose more on you. I don't blame many doctors for not wanting to feed the machine."

Indeed, retired anesthesiologist Joseph Comfort, MD, told WSJ that doctors now "are like any other employee, and that's how the new generation is behaving."

Cardiologist Ali Haider, MD, that "it was a different world back then, with different physician autonomy, less corporate influence, more reimbursement, less administrative work, and more actual medicine. We have to adapt to the times as both the field and society change, it's as simple as that."

There's also been an evolution in the thinking around medicine as a "calling," the WSJ article noted.

Joel Katz, MD, who has run the residency program at Brigham and Women's Hospital in Boston for two decades, told WSJ that he saw attitudes evolve over that time. While doctors used to say their work was a calling, now, it's considered "very triggering and offensive."

"It's code word for being taken advantage of," Katz told WSJ.

Nonetheless, physicians acknowledged finding some middle ground with certain perspectives in the article. Joel Zivot, MD, an anesthesiologist at Emory University in Atlanta, said he doesn't think young doctors are "simply shiftless and lazy. I do think, however, that if they imagine that happiness lies in the elusive space between work and life, well, they will be sadly disappointed."

Nelson acknowledged that there currently exists "a frustrating disconnect between student and resident beliefs and needs, and those of the healthcare system."

"Both 'sides' need to manage their expectations and adapt to the new reality," he said. "It is likely that this adaptation will be slow and contentious and this has major implications for them and our patients and communities."

Physicians offered ways to adapt to that reality. Rachel Weinerman, MD, a reproductive endocrinologist with University Hospitals in Ohio, told 番茄社区 in an email that there's "no one 'right' way to practice medicine, and multiple models exist that allow for greater flexibility in physician schedules while ensuring excellent patient care."

That includes team-based care and shift-based hospital care, she said.

"Ultimately, physicians will be satisfied with their careers if they are compensated fairly and working at the top of their license and abilities, minimizing busy work and administrative tasks," Weinerman said. "In the absence of these factors (which occurs all too often), it makes sense physicians will seek more autonomy of schedule and personal time to combat burnout."

Rachael Robertson and Cheryl Clark contributed reporting to this story.

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