I took a second to review my surroundings during a clinic lunch one day. Another young provider was engaged in conversation with the guest speaker. A seasoned, middle-aged nurse quietly ate her meal while glancing at the materials. At the end of the table, two young nurses and a shadowing premedical student sat with their eyes glued to their cell phones. Another provider nearing retirement age was nowhere to be found. As usual, he was still in clinic booked through most of his lunch break. This really got me thinking about generational dynamics and its impact on medicine.
What generation are you?
I am not a fan of lumping large groups into a box but I am also not ignorant to the fact that generalizations and assumptions are at times helpful. As a proud 80’s baby, I guess I am considered one of those millennials or “Gen Y” guys. Recently, we millennials have been plagued with not so flattering adjectives such as lazy, impulsive, disengaged, and of course… entitled. However, we are also positively recognized for being accepting, tech savvy, resourceful, and entrepreneurial. My generation has entered the workforce over the past decade and have had to navigate through the stock market crash, housing bubble, social changes and borderless wars. At the same time, those of us who have chosen to be physicians are finding our way through a rapidly evolving medical field. Speaking to premeds across the country, I have come to realize that many are now classified as the generation Z or post-millennial cohort. As emerging adults, some of you are college students and others are nontraditional students attempting to find yourselves. We will soon be welcoming you into the profession so I thought I would briefly share three key areas I have observed across the past few generations.
Communication:
This is one of the most overlooked area I have observed in medicine. The fact that a team spanning 3-4 generations are now able to share the same clinic space, there is bound to be some type of conflict. I still feel uncomfortable hearing staff or patients who are baby boomers call me “sir”. I have learned to kindly accept this from them but never allow it to puff up my head. Some older staff are not welcoming of change and want things done the way they’ve always been while many millennials want a more modernized surrounding. I believe the younger members should occasionally set their gadgets aside and learn from the older staff about their interesting cases and techniques. Medicine to some baby boomers and generational X docs has shifted from an art to cookbook medicine. I also think the older staff can spend time with the younger ones in order to learn about tools that can enhance their style of care. Too often, these bridges are not formed and we stay in our own generational worlds.
As a physician, your communication with the patient is demonstrated through your bedside manner. I had an elderly patient last week look at me in awe as I auscultated her lungs. Soon afterwards, she smiled at me and said, “I was just so shocked that you young docs these days still do that.” Apparently, she and many others feel as though they aren’t even touched by the younger physician anymore. Many baby boomers are adapting to the diverse physician body and new tools used. Some are resistant to these changes while others welcome them gladly. There is a constant battle these days for face-to-face interaction with patients heavily due to the electronic medical records with all of the check boxes we must cover during each visit. This has been tough for us millennials but even tougher for the baby boomer and generation X physicians. Unfortunately, a number of seasoned docs have left medicine or have been forced into early retirement due to these changes.
Lifestyle:
This has significantly evolved over the past 50 years. I encourage you to take some time to speak to a baby boomer physician about their medical practice in the 70s or 80s. If you do, I hope you’ve got some time on your hands. Many conversations will start with, “Ahhh, the glory days of medicine, those were the days.” As you listen further you will realize that many of them worked hard. Super hard. Many found their identity in their work and medicine was a very well-respected field. Some would do house calls and there were no safety laws keeping them from performing 24-48 hour shifts as residents. The Sunshine Act was not in effect at the time, so some physicians of that day took vacations on the pharmaceutical company’s dime. Some of you may have physician parents who you rarely saw while growing up. Much of this has now changed as work-life balance has become a priority for many in the gen x and millennial groups. It is important for many of us to be present for our child’s dance rehearsal or soccer game. Many younger docs find positions where they can work part-time to raise a child and some even take on hobbies or side businesses. Dual degrees are becoming more and more common these days as we want the freedom to contribute to the world outside of the clinic as well.
The Future:
There remain a ton of problems with healthcare yet to be solved including expenditures, disparities, access to health, cost of schooling, and physician shortages. Many in the baby boomer and generation X groups feel disengaged in politics and business. Some come across as apologetic that medicine has slipped out of our hands as the local family medicine clinic is bought by the large hospital chain and new laws are placed forcing us to spend more time on notes than with the patient. I remain optimistic that these challenges will improve with my generation and the generation Z. I’m excited to see younger generations display courageous actions in their fight for better gun control laws. My generation faced the Columbine massacre but had little means to express ourselves. We applaud generation Z. I am amazed by premedical students standing up for social injustice at their state capitals. I see young docs and premedical students take the lead in creating apps and nonprofits benefiting hundreds to thousands of people’s health. This leads me to have hope that these problems can and will be solved one day. I am very excited about what you will bring to the field of medicine.
I’d love to hear what generation you belong to and what ways you think your generation will impact medicine.
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