The winds of change for our healthcare system are blowing at a gale force. The issues of excessive cost, mediocre quality, and limited access must be addressed, although it is not economically possible to address all three at the same time. Forces for change are coming from multiple areas, including payers, providers, patients and the government. Included in the forces of change are the young physicians who are members of the generational groups known as Generation X and Generation Y. In addition to the changing gender make-up of physicians (one-half of current medical school students are female) the future leaders of the medical profession represent a generation gap from their Baby Boomer Generation predecessors.
In contrast to the Baby Boomer Generation, the members of Generation X and Generation Y are highly tech-savvy (notice the smartphones and tablets), and are more comfortable with the concept of team approaches in rendering medical care. Of even greater importance, these two generations are oriented towards a work-life balance in which being a physician is only a part of their self identity. They have adopted the healthy attitude of working to live, not living to work.
The generational differences are being reflected by surveys of residents and medical students conducted by physician placement firms. A 2012 survey of graduating medical residents by Cejka Search revealed that 46 percent expect to join a group practice, 29 percent prefer a hospital practice, 95 percent prefer a suburban community, and 68 percent prefer a salaried position. A survey by Merritt Hawkins showed similar preferences, with 32 percent preferring hospital employment and 94 percent preferring communities of 50,000 or larger. Other surveys have reflected the small percentage of graduating medical students who plan a career in primary care fields.
A summary of preferences of Gen X and Gen Y practitioners would suggest that they are likely to be salaried, located in larger metropolitan areas, comfortable in integrated-care teams, and not practicing in primary care fields. These characteristics may affect the organizational structure of healthcare as much as any of the other forces for change.
Dr. Forney Fleming heads up the Healthcare Management master’s program at UT Dallas. He joined the university after decades of working as an orthopedic surgeon.