Not another “those damn Millennials!” post. ‘Fraid so. But here’s the thing: Work hour restrictions may have some unintended consequences. They include millennial doctors who are a) less prepared to join a workforce of baby boomer colleagues and b) physician burnout. Dr. Drummond, who is CEO of The Happy MD and author of Stop Physician Burnout, delved into the causes of and possible solutions for burnout. This week, he explains how the changing work culture brought on by new physicians is exacerbating the issue. Drummond says it was once common for doctors to work 36-hour shifts every third day for a month or more. He can remember working 126 hours in a week on an inpatient pediatric rotation his internship year. “That has consequences,” he says. They include suicide, poor patient outcomes, and mistakes due to physician overload. “We are completely exhausted, yet we keep showing up no matter what. It’s a piece of the never-show-weakness programming” that also leads to burnout. While overwork certainly leads to physician burnout, it seems that so can underworking doctors in their residency. “What ends up happening is the current generation of doctors, trained in an environment of work hour restrictions, are not pushed as hard as the boomers. As a result, they aren’t as thoroughly conditioned as we were” he says. “The screws were put to our generation and before. The screws were intentionally unscrewed for them.” Less Prepared Fewer hours spent working during residency also means less knowledge acquired. That leads to a more prolonged onboarding process for new physicians in their first clinical jobs. Drummond says this also leads to, “an early flush of burnout in recent residency graduates as they try to keep up with boomer colleagues and are suddenly asked to work harder than they have ever worked before.” Work hour restrictions have also played a role in worsening the physician shortage. Drummond explains that millennial physicians often won’t accept the baby boomer’s definition of “full time,” which can be in excess of 60 hours weekly. It is common for a Millennial new hire to request 0.8 FTE instead. Historically, CMOs may have not offered a less-than-full-time option. Now that multiple qualified candidates are turning down 1.0 FTE positions, CMOs are offering less than full time to new hires in order to meet patient volume demands. This steady drop in the workload of group members only exacerbates an existing physician shortage. Older physicians, who are still working on the old FTE definition, will often follow suit, requesting the same 0.8 FTE option. With younger and older physicians working less, the pressure increases on those remaining physicians working full time and full speed. It is not uncommon, Drummond says, to hear these Baby Boomer physicians say things like, “These new doctors don’t know how to work hard and they just don’t care.” Drummond says in actuality, “The new generation of doctors works differently and cares differently and have better boundaries than doctors my age. They are redefining the meaning of full time for all doctors. “It remains to be seen how healthcare will address the worsening doctor shortages in the years ahead as the gladiator style work hardening of the good old days comes to an end.” TL;DR Millennial doctors, shielded from longer residency hours, may not be as prepared for the stress of actual life as a doctor. This could be contributing to physician burnout. Their desire to work shorter hours is also contributing to the doctor shortage, and perhaps indirectly leading to secondhand burnout, as well. Source
