Physicians aren't what they used to be -- neither is a life in medicine

LETTER — Posted March 22, 2004

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Regarding "Younger doctors less dedicated, hardworking?" (Article, Feb. 2): If young doctors are, in fact, less dedicated and hardworking, let me propose a few reasons why this might be the case.

As a young doctor about to enter practice, I am not naïve to the reality that the golden era of medicine is over. Much of what made internal medicine enjoyable has been lost.

In training, there are fewer positive role models, less time for and interest in teaching, and more testing/licensing hoops to jump through.

As we enter practice, deeply in debt from our medical school loans, we inherit a medical system in shambles.

Reimbursement is low.

Autonomy is low.

Job satisfaction is low due to ever-increasing levels of bureaucracy.

Rewarding, long-term doctor-patient relationships are a rarity now that patients must frequently change doctors as mandated by their health plans.

Amid this, we also see many older doctors with failed personal lives. I have a friend who delivered more than 6,000 babies during an esteemed career as an ob-gyn, only to have his marriage end in divorce and his children grow up resenting him because he was never around for them.

For those fortunate enough to sustain a healthy family life, it is likely that they had a stay-at-home spouse who managed the family affairs, allowing them to focus solely on their careers.

Such arrangements are rare these days; more participation in family matters is expected from doctors, both male and female.

This does not preclude a fulfilling career in medicine; we simply need to harmonize the realities of practicing medicine with our other obligations in life.

This is achieved through balance. We are looking for role models.

David Liljenquist, MD, Chicago

Note: This item originally appeared at http://www.ama-assn.org/amednews/2004/03/22/edlt0322.htm.

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