More feedback on yesterday’s study suggesting that older physicians are bemoaning the resident work-hour restrictions. retired doc comments:
This is not a hard data article but a presentation of the impressions of IM resident training program teachers most of whom trained in a era that was very different. One difference is that many faculty likely grew up medically with their limbic cortices branded with the concept that as a professional obligation they should place the needs of the patient above their needs and the primacy of that directive seems no longer to hold the same exhaled position in the medical ethical scheme.
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Choosing a specialty that offers a balanced or attractive “lifestyle” has absolutely nothing to do with professionalism. Nothing at all. Program directors that suddenly find fewer high quality graduates seeking training in their (erstwhile) well-regarded residencies need to find someone else to blame for that trend in career interest. What is surely isn’t is a decrease in “professionalism.” Wanting a practice specialty that offers reasonable hours and reasonable pay is, well, reasonable.
“I had to do it, so you have to do it.”
Underlying all the bullshit, this is why these old guys are advocating for “the good ol’ days.” They are bitter, and had to do it…and love to see people suffer, because they had to.
I would not want one of these physicians to treat me, or anyone I care about. At their core, they are selfish and dishonest. Hardly a demonstration of professionalism!!
There is certainly some of that. I think also, especially for the pre-baby boom docs, their perception of a lower level of personal commitment in residents today is somewhat accurate. Part of the reason is the general social change of increasing narcissism with the generations that followed theirs.
Another factor, in my opinion, is the inevitable corrosive effect of the loss of professional autonomy on the sense of responsibity. Responsibility and freedom are inextricably yoked. With the decline of the latter due to cookbook medicine, socialized payment systems, and declining respect for physician authority, then younger physicians do indeed feel less responsibility.
As a utilization and quality reviewer, I hear shocking comments from some of the younger docs that reflect a disavowal of reponsibility for the care process, showing a view of themselves as just another member of the team without real responsibility for the actual net result as far as getting things done.
I do support the work hour restrictions as I don’t think we can teach people to be humane to others while treating them inhumanely. I though so when a resident (with no hour restrictions) and am glad to see the next generation to not have to put up with that masochistic BS. I don’t think that the restrictions are the cause of declining professionalism–it was already in place due to even more powerful forces.
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