Why do young doctors hate medicine so much?

There is a perpetual mentality that generations after our own seem more entitled than we ever were ourselves.  Since when did a second grader ever need the latest cellphone?  Avocado toast, month-long honeymoons, extended vacations after residency, and baby moons are just some of the luxuries that prior generations were unlikely to have experienced.  Maybe society is simply more advanced, or maybe I’m just getting old.

In the medical world, more doctors are asking for more time off, shorter workweeks, less call, and more pay. No way would younger doctors willingly sign onto a job with a call schedule of every other day. Is quality of life that much more important to us even though many recent graduates have upwards of a quarter million dollars of educational debt? I once had a senior partner who opted to take more hospital call when he was in his thirties so that he’d earn more to support his family.  What happened to good work ethic?

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I see this trend in doctors not only in generations after my own, but also in a few years my junior. They seem to be working less, wanting more, but all seem to hate medicine. Some of these gals are doing amazing things, like resuscitating dead people, putting in new heart valves, and curing cancer. What is there not to like?

What gives?

Medicine offers a lot to be disgruntled about.

If you remove the aspects of patient care, healing, and all of the reasons why we became doctors, there really isn’t much left over to praise. Prior authorizations, meaningful[less] use, patient satisfaction scores, inordinate amounts of charting, useless meetings, and reimbursement cuts are just some of the recent inventions in medicine that erode the enjoyment out of medicine.  Autonomy frequently gets replaced by mandates. How sad.

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The irony about these unfavorable healthcare mandates is that most of our administrators tell us that with a little more hard work, we can accomplish all of the expected tasks. Most doctors are not opposed to working hard—we did go through a decade of servitude in order to master our specialties—but the problem with the ancillary tasks associated with medicine is that there is little perceived return in our effort.

The intention of these time consuming tasks associated with medicine is primarily to improve safety and cut costs in the healthcare system. There are so many layers in the bureaucracy that it is essentially impossible to determine whether working doctors harder is going to pare down the cost of healthcare.

Follow the Benjamins and you will realize why doctors are unhappy 

Capitalism.  I love it. If it works well, there is a direct correlation between hard work and return.  Unfortunately, capitalism doesn’t always work if you’re an employed physician.  The reward for completing more charts and seeing more patients doesn’t always translate into direct financial gain.  In fact, if you save the healthcare system more money you might actually benefit the guy in the C-suite or the company’s stockholders first.

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Several weeks ago, I was in a meeting where one of the administrators in my organization (who holds a pseudo-degree from an online for-profit institution) alluded that one of the trauma surgeons ought to be working harder given that the group was paying him $X. That amount was about a third of what a normal trauma surgeon ought to be earning.  I was blown away that this trauma surgeon was even willing to work for a fraction of what he is worth.  I was even more shocked to hear that the administrator thought that the surgeon was overpaid.

These instances reflect that people holding the power in healthcare still believe that doctor salaries play a role in cutting down the cost of healthcare.  One hospital that employed 60 doctors reported a deficit of $87 million.  There is a problem when you think that cutting your neurosurgeon’s salary is going to solve that problem.

Do doctors who aren’t considered young have the same sentiment?

In general, we all do. The difference is that doctors who have been working twenty or thirty years are in a different point their careers.  Most of their children who are out of the house and even self-sufficient.  Some of them even practiced medicine in the heyday and hopefully invested their earning appropriately. Maybe some of them are financially independent.  They are no longer in the earning phase in their careers, so many of the burdens that we endure do not necessarily impact their long term career plans. If the hospital mandates too many EHR clicks or an excessive number of patients per day, they can just hang up their hats and ride off into the sunset.

What can younger doctors do in this situation? You already know the answer if you’ve read this far. Make it so that you, too, can ride off into the sunset if you have to.

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