Journalist Te-Ping Chen wrote about the nature of a physician’s career in a recent featured article in The Wall Street Journal where older physicians criticize the younger generation as being less committed to their patients. The article is titled: “Young Doctors Want Work-Life Balance. Older Doctors Say That’s Not the Job.”
The major point of discussion was the definition of a career in medicine as a “calling” versus a “job,” the implication being that, just as with any other job, younger doctors were behaving like other workers who walk away at the end of their shifts on the assembly line when the horn blows for quitting time.
The article features quotes from older physicians bemoaning the loss of physician autonomy, as most doctors are now employees of hospitals and large corporations. One older male surgeon mentions his continued feeling of obligation and willingness to take around-the-clock call, something younger physicians no longer want to do. The work ethic and commitment of the younger generation are absolutely called into question by the old guard.
The article points out that younger physicians want a better work-life balance, and the older ones say that is not the nature of the job. Younger physicians are noted to have both children and parents they must care for. Younger physicians, even the males, say they can’t possibly give up those obligations for the constant demands of their patients. No one mentions the ugly old elephant in the room: the structure of the patriarchy.
That old system where the physician could drop everything and hurry into the hospital at night to perform emergency surgery was based on a system in which surgeons were men married to women who supervised the children at home. The realm of physicians was populated almost entirely by men. They were either single men with housekeepers or married men with wives who tended to the children, the cooking, the cleaning, and the schedules. If the physician had to miss a recital or ball game, so be it.
Few women attended college, and even fewer worked outside the home. Now, more than fifty percent of medical students in the United States are women. Today, many young men and women meet while in medical school and marry their fellow students—physicians. When physicians want to have children, the childcare load must be allocated between two physicians or one physician and one spouse who likely also works outside the home.
There are soccer games to attend, birthday parties to chaperone, and music lessons to drive the kids to. Today’s physicians may also need to bring grandma to the doctor’s office or take an unplanned trip to the emergency department. Younger physicians do not have a wife at home to take care of everything while they go back to the hospital for an emergency.
This is why younger physicians need their off-time protected and respected. They need to be able to call out sick so they can rest and heal. They should not be working while miscarrying or feeling ill. Today’s physicians need to have their health and time respected.
The medical system has changed in many ways. There are so many more immediate interventions that must be taken by nurses and physicians at the bedside. Procedures must be done within the hour by physicians who are present in the hospital. Virtual doctors and nurses cannot do it all.
The patient absolutely comes first when we are in the room with them. When we need to go home, another physician, who feels fresh and well-rested, can take our place. Limiting work hours is safer for patients and better for busy physicians with other obligations to meet. We can be great moms, dads, daughters, sons, and physicians.
The foundation of the antiquated around-the-clock call system was built on the around-the-clock presence of the wife, mother, and homemaker of yesteryear. Those days are over. Today’s physicians are charging into their lives with children, pets, parents, and themselves to look after. They are dedicated both to their patients and to their own families and their self-care. This is exactly the way it should be.
Joan Naidorf is an emergency physician and author of Changing How We Think about Difficult Patients: A Guide for Physicians and Healthcare Professionals.
