Generational Change and Leadership

I was recently speaking with a CMO, we’ll call him Jim (not his real name) about the current problems in healthcare. I wanted to get information on how people in hospital leadership positions view the current status of healthcare. I wanted their expertise and unique viewpoint. Jim said his biggest challenge was staffing. I’m sure that’s not a surprise to anyone. He said, it affects not just doctors and nurses, but also techs, and clerks. He is challenged with always trying to fill gaps.

He said his second biggest problem is “generational changes,” I wanted to learn more about that, so I asked him to elaborate. Jim said that physicians have become blue collar workers with no one taking ownership of the patient. Jim told me that he agreed with the idea of work-life balance, while mourning the days when doctors stayed and took care of their patients, no matter what. He said that younger doctors don’t want to work. He reminisced about the times when physicians stayed late, rounded early, and did whatever was necessary to take good care of their patients.

When I asked him how these two situations made him feel, he said the first made him feel frustrated, and the second had him dismayed. Then he elaborated on feeling frustrated. As a physician, he is frustrated by the lack of control he has over his practice, and the demands on his time and skills. (Control was his word, not mine). Jim repeatedly used the phrase “loss of control” to describe the changes that have occurred in Medicine since he began his career roughly 30 years ago. “Physicians have become blue collar workers,” with no control over their patient load, their hours, or their income. He used the word frustrated, and he sounded angry. I said this might be why physicians and other healthcare workers don’t want to come to work.

Jim nodded in agreement, then put on his administrator cap. He blamed staffing problems on generational changes in healthcare workers, rather than their sense of a “loss of control.” While Jim agrees with the idea of work life balance, he feels that a bigger problem is that physicians no longer have a sense of “ownership of the patient.” He explained that this sense of ownership drove our desire to provide excellent seamless care for our patients. The new generation of physicians never had that ownership and older, more experienced physicians, have lost it.

He copes with this frustration and dismay through his faith. He believes that physicians should look to a higher power and “go to the Creator of the universe,” for the answers to healthcare’s problems. While a belief in a higher power is the Creator of the Universe, he feels faith is a strong driver of better care. Jim also believes, quite strongly, that physicians need to take back ownership through self-sacrifice. When I asked if there should be any limits on this self-sacrifice, he said, “No. Do whatever it takes” to ensure the patient has a good experience.

He then mused that his own attitude toward Medicine changed when he sold his solo practice to become a hospital employee. Since he does not reap the direct financial benefits of his labor, he sees no reason to stay later, work harder, or pick up extra days of call. This bothered me. He was describing in himself the exact same behaviors he had criticized as “generational change.” This is a man who has input on the workload, call schedules and reimbursement of over a hundred physicians. Is he being duplicitous? Is he projecting? What do you think? How would you have responded? Are these the thoughts and behaviors of your leadership where you work? What is the impact of that on your life and career?