The Next Physician Migration

physician rotation and burnout[GUEST POST BY PAUL ROSEN, MD] When I graduated medical school almost 20 years ago, the majority of my classmates were planning to work in a private practice environment after residency training. Now, the opposite is true. Ninety percent of medical students plan to work for a health system. Most will skip private practice work.

However, senior medical students, when they rotate in hospitals, are having second thoughts. They see an ecosystem that does not embrace the latest technologies. Or one that does not value work-life balance, and that perpetuates work habits that have been around for centuries.

Physician burnout and the call of career alternatives…

They are being mentored by physicians in practice who have a greater than 50 percent burnout rate according to the latest calculation by Mayo Clinic.

The number of alternative career choices for medical students is exploding. Students in close proximity to intense healthcare start-up activity such as San Francisco, Boston, New York and Philadelphia are weighing their options.

In my day, most students were thinking about their future 30-year career in one job. Currently, students are deciding between a three-to-five year stint in clinical practice before exiting. Or they are skipping practice after residency, or just skipping residency all together.

Many millennials do not see the value of working 30 consecutive hours. Are they lazy? No, they are smart. They know that working while sleep deprived does not do anyone any good- them or their patients. The millennials value work-life balance, performing social good, and working in a fun, team-like environment. They will seek jobs that resonate with their values.

The health systems need to change their management model and fast. Most senior physicians are planning an early retirement due to high burnout levels generated by working with electronic medical records, a feeling of loss of autonomy, and lack of alignment with senior leadership.

Couple that with the fact that fewer future medical students and residents will be signing up for the mega-corporate health system for long periods of time. Instead, young doctors will be able to see patients from their homes on their smartphones at hours that they control.

An estimated 90 percent of health systems are not actively working to relieve physician burnout. A few are building formal burnout prevention programs. And physicians are assigned as chief wellness officers to put a major focus on the issue.

The direction of the next migration…

If large health systems do not radically change how doctors are managed, they will have a harder time finding doctors to staff their hospitals. With physician suicide rates more than twice the general population, and rates of medical student depression as high as 30 percent, young doctors of the future will abandon health system jobs for more nurturing environments. That just may be their living rooms.

Paul Rosen

Note: Paul Rosen, MD, is a frequent contributor to our blog. When he is not writing about patient experience, he practices as a full time clinical pediatric rheumatologist at Nemours.

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Paul Rosen

Paul Rosen

Pediatric Rheumatologist Paul Rosen, MD, is Clinical Director of Service and Operational Excellence at Nemours. He received a Masters of Public Health degree from Harvard University and a Masters of Medical Management degree from Carnegie Mellon University. Dr. Rosen’s interests include patient-physician communication, family-centered care, and the patient experience. He teaches medical students about improving the patient experience, and he serves as the faculty mentor for the physician executive leadership program for medical students at Sidney Kimmel Medical College at Thomas Jefferson University. Twitter @PaulRsn1

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