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Pⁿ Blog
The Pⁿ Blog is a forum for opinions, questions, controversies, and instructive discussions across the field of pathology and its relevant subspecialties.
Wednesday, August 14, 2013
Generational Differences and the Affordable Care Act.
If you don't read the "Dark Daily" for updates in clinical and anatomic pathology news and trends, you're missing some good reading.  A recent edition dealt with how different generations are approaching changes in healthcare.  This article in Dark Daily is actually a review of an article by Sean Murphy published in Modern Healthcare in July 2013.  So here, briefly, is a review of the review to hopefully tempt you to go to the primary source. 
 
The study by Dr. Murphy indicates that baby boomer doctors are rebelling against the coming changes in medicine. They value patient relationships and their independence to make medical decisions.  In contrast, younger physicians like the new paradigm of hospital employment because it provides a balanced life and predictable workday schedule where the patient sees the next available doctor if their regular doctor isn’t available. 
 
One major disagreement between these two generations is how a patient will be handed off from one physician to another, since the Gen X and Gen Y physicians don’t want to be available 24/7, unlike Baby Boomer doctors, who often do. Younger physicians believe that the routine transfer of patient care from one physician to another shouldn’t be a problem because the mandated electronic medical-record systems.  In contrast, older physicians (baby boomer doctors) say this isn’t the way medicine should be practiced, and they aren’t going down without a fight. To them, being a doctor means a 24/7 commitment to patients and sustaining personal relationships.
 
The above is an interesting argument for which some data, at least in an inpatient teaching hospital context, are already available.  With the crackdown on resident hours a few years ago, there was hope that this would prevent medical errors caused by overly tired residents.  Howver, the data seem to indicate that such errors have essentially been replaced with "handoff" errors, even in this day of EMR's.  If you're an inpatient, sometimes you're better off with a tired resident who is intimately familiar with your case as opposed to a "fresh" one who doesn't know what's going on.
 
Regardless, of how you come down on this argument, this is a battle that Baby Boomer physicians are not likely to win. In fact, while hospitals, insurance companies, and big pharma are all likely to do well under the affordable care act, doctors who are after all the backbone of healthcare may become the sacrificial lambs.  Time will tell.
9/11/2013
Dr. Gerson Paull said:
"The future isn't what it used to be." (French poet Paul Valery)
About the Author

Stacey E. Mills, MD
Stacey E. Mills, MD, a graduate of University of Virginia (UVA) and the UVA Medical Center, has authored nearly 230 articles, 20+ books, atlases and monographs—including the renowned Sternberg's Diagnostic Surgical Pathology. He has been a practicing Professor and Staff Pathologist at UVA for 30+ years and is Director of Surgical Pathology and Cytopathology. His clinical specialty is general surgical pathology with emphasis on neoplasms and neoplasm-like lesions. Dr. Mills is also Editor-in-Chief of The American Journal of Surgical Pathology.