Radiologists and other physicians question medicine’s ‘workaholic culture’
An article published by the Wall Street Journal Sunday is causing a stir among radiologists and other physicians.
The Lifestyle section piece notes that, for generations, doctors have accepted being at the “mercy” of their pagers, working long hours with little time for family. However, the newest generation of docs has pushed back against this mindset, seeking more work-life balance and less stress.
The discussion mirrors another recent conversation, covered by Radiology Business in August, with one radiologist pondering why younger doctors seem disinterested in volunteering for lucrative extra shifts.
“All us old guys are taking ER call, and you got guys in their 30s at home every night,” Jefferson Vaughan, MD, a 63-year-old Florida surgeon with 30 years’ of experience, told the WSJ. “It’s just a sore spot.”
Almost 50% of physicians report feeling some symptoms of burnout, according to the American Medical Association. A growing number are now working as employees at hospitals instead of in private practice, and increasing bureaucratic demands only add to the stress. WSJ’s Te-Ping Chen interviewed almost two dozen physicians, with many agreeing that “medicine’s workaholic culture was overdue for a correction.”
Some are choosing to join larger organizations rather than starting their own medical group. Of physicians under 45, only about 32% own practices, down from 44% in 2012. That’s compared to about 51% among physicians ages 45-55. Joseph Comfort, MD, an 80-year-old anesthesiologist, sold his own practice in 2003 after growing frustrated with fighting insurance companies.
“We’ve been ripped down off our pedestals,” he told WSJ. “We took [the long hours] because we considered ourselves to be masters of our own fate. Now, everything’s changed. Doctors are like any other employee, and that’s how the new generation is behaving.”
You can read much more of the discussion in the Journal here. Radiologists shared the article on social media Monday while weighing in on the debate.
“As more physicians become employees and are less engaged with the actual ownership of medical practices, it becomes easier to think of what we do as just a job. If there are no positive benefits of ownership, such as autonomy, flexibility, financial benefits, we will become shift workers and health systems aren’t ready for that,” wrote Tarang Patel, MD, a radiologist and podcaster based in Scottsdale, Arizona. “They want employed physicians badly to counter the disasters they got with private equity, but leadership should be careful about… going towards the fully employed model. It may cost the system far more than they realize.”
Nisha Mehta, MD, a radiologist and founder of Physician Side Gigs, said the article has “caused a stir” in the online community, which boasts 190,000 physician members. She believes the issue is being oversimplified, and that the newer generation is not just “entitled millennials who don’t want to work 60 hours/week.” Rather, what used to make these long hours sustainable has changed due to “shifts in physician demographics and the pressures of practicing in today’s healthcare landscape.” Mehta cited increasing administrative tasks, lack of autonomy, and physicians forced to shoulder family caregiving duties at home.
“The point is, for career longevity, physicians have got to have daily reminders of what they love about medicine. It can’t be all the pressure to do more with less resources, people taking advantage of their altruism, and people telling them how to do their jobs,” wrote Mehta, who is based in Charlotte, North Carolina. “Do we need to change the culture of medicine? Yes. But also, let doctors be doctors, and you’ll see how many of them happily work 60 hours a week.”
Her post had generated over 230 comments and 130 reposts on LinkedIn as of late Monday.
“Everything you wrote here is why I'm leaving my large group primary care practice of 13 years,” responded Cora Ludwig, MD, an internal medicine and obesity physician based in Happy Valley, Oregon. “It's not that I don't want to work hard. I like working hard. But I'm tired of being used for my altruism, for my labor, when what I want is time to connect with my patients and provide them with what I know is the best possible care.”
Benjamin Mazer, MD, a surgical and gastrointestinal pathologist based in Baltimore, also shared the article, contending that the WSJ had “woke up and chose violence.” His post had garnered 200 comments and 2,000 reposts late Monday.
“This really highlights the natural shift in worldview across generations,” responded Amine Korchi, MD, a radiologist, entrepreneur and healthcare commentator based in Switzerland. “Each one has been exposed to different events and contexts, each one with its own approach to work-life balance and priorities—a reflection of changing times and values.”
“Older docs should retire and let us take over. It’s just a job, you don’t have to sacrifice your life over it,” added Shariq Shamim, MD, an interventional cardiologist in Missouri.
“I think, in all fairness, both are right,” wrote Douglas G. Adler, MD, a Denver gastroenterologist. “Work/life balance is important (although I am not good at it), but medicine is not that kind of job. You have to be committed to your patients and that often translates into long hours to get people taken care of. A tough balance.”
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.