Latest news with #physicianculture
Yahoo
19-07-2025
- Health
- Yahoo
Lewis: Regina hospital physician culture is both tragedy and farce
Life is short, and based on a lifetime of experience with the genre, I cannot recommend you spend much of it reading reports on health care. But should you find yourself awaiting a root canal, a phone scroll through the 2024-25 External Review of Regina Hospital Physician Culture might make you feel a bit better about your impending chair time. In a bracing 30 pages, including appendices, the report describes a litany of dysfunctions among physicians working in what is supposed to be the most professionally managed precinct of health care. It's not all bleak. There are no allegations of American-style billing for non-existent surgeries or fistfights in the doctors' lounge. But it is plenty bad enough. The highlights: Physicians in Regina have largely held themselves apart from the mission, vision and values adopted by the SHA (Saskatchewan Health Authority) since its formation in 2017. We heard examples of divisions and departments where it appears pursuit of financial compensation has overtaken the priority for high quality accessible care for patients. There is no functioning electronic health record, and no database that allows either effective wait list management or workforce planning. The Ministry of Health allows interests to plead their cases directly, undermining the SHA mandated to run the system. Whether rooted in illness, aging or personality factors, disruptive patterns of behaviour have often been in place for many years and not addressed in a decisive fashion. Very few physicians were able to describe how they monitor and improve quality in their services. Leaders who have identified problematic behaviours and acted appropriately to protect patients and teams should not be vilified or suffer retribution. In some cases, efforts to recruit have been thwarted by physicians to preserve their service volumes despite wait times. There are legacy contracts, deals and arrangements that create inequity and inconsistency in negotiating with physicians and groups. It is embarrassing to have to commission a review to make blindingly obvious recommendations. A report on a school system in similar disarray would recommend having principals who are actually in charge. The schools should teach the students to read and write. They should know what students' needs are and organize to meet them. There should be no side deals and special privileges for a few teachers. Records should be computerized and generate data to plan and assess performance. Evaluate your staff. Discipline teachers who throw tantrums and abuse their colleagues. Is it any wonder why people misbehave when bad behaviour is not only tolerated, but rewarded? The Regina physicians have told the SHA to park its mission, vision and values where the sun don't shine for eight years, with zero consequence. So much for a unified provincial system. Medical groups have frozen out new recruits to protect their incomes while wait lists ballooned. Physician leaders who tried to impose some order and civility were abused and left hung out to dry. Don't for a moment think these problems are unique to Regina. Do a quick search of conflict of interest in Alberta, or pediatric chaos in Kelowna. The only difference between Regina and dozens of other communities is that Regina's pathologies are now out in the open. Like all reports written by physicians about physicians, professional self-governance is assumed to be entirely in the public interest, fully compatible with fulfilling public and professional obligations found routinely unfulfilled, and despite acknowledgement that 'some physicians have lost the plot of why we are here.' And therein lies the problem. The report says as much: 'Physician autonomy is clashing with the broader social contract to ensure quality and safety.' Workers at Starbucks or Toyota can tell you how their work is organized and monitored to produce quality. Most physicians in Regina are tongue-tied. This is what you get when a profession is accountable to itself, and self-evaluation in a data-free environment is standard operating procedure. A cultural problem? Sounds so much more anthropological than negligence, cowardice, greed, and abdication of responsibility. As a wise physician friend told me years ago, what you permit, you promote. The rot has been called out. What next? Steven Lewis spent 45 years as a health policy analyst and health researcher in Saskatchewan. He can be reached at slewistoon1@ The Regina Leader-Post has created an Afternoon Headlines newsletter that can be delivered daily to your inbox so you are up to date with the most vital news of the day. Click here to subscribe. With some online platforms blocking access to the journalism upon which you depend, our website is your destination for up-to-the-minute news, so make sure to bookmark and sign up for our newsletters so we can keep you informed. Click here to subscribe.
Medscape
09-07-2025
- Health
- Medscape
Is Gen Z Changing the Culture of Medicine?
Do you cringe when you hear the phrase 'Okay, Boomer,' or do you flaunt your Gen X status by wearing T-shirts from your favorite 80s bands in your off hours? Whether you strongly identify with your generation, there are generational stereotypes that persist — and those stereotypes or beliefs can influence how you are perceived by patients and colleagues and how you perceive them. For example, in the workplace, Boomers are often assumed to have strong work ethics, while Millennials tend to value their free time more than preceding generations. While generational generalizations have shortcomings (as do all generalizations), the incoming crop of Gen Z doctors will likely affect the culture of medicine in significant ways. About Medscape Data Medscape continually surveys physicians and other medical professionals about key practice challenges and current issues, creating high-impact analyses. For example, Medscape's Physician Workplace Culture Report 2024 found that 6 in 10 physicians feel their workplace culture was holding steady if not slightly improving. Doctors younger than 45 years found culture more important than pay. Physicians argued that a supportive, positive culture was not only practical but also possible. 54% were committed to work-life balance. The Shift Is Already Underway 'We're already seeing a shift in expectations and practice patterns that mirror many of the values this generation brings: work-life balance, transparency, and a desire for a more human-centered model of medicine,' Corrin McCloskey , MPH, executive director, Heart and Vascular Services at Tanner Health System in Carrollton, Georgia, who works with cardiologists of different generations, told Medscape Medical News . Yet these expectations may not be welcomed by the 'old guard.' 'Often there is a sense from one generation to the next that they [the new generation] don't want to work as hard,' said McCloskey. 'It's not that Gen Z doesn't want to work as hard. But they're setting expectations about what their work is going to look like and what they want their lives to look like outside of work…there's a perception that older physicians built their practice through blood, sweat, and tears, and the younger generation does not want to do that.' For example, incoming doctors often seek positions where they don't have to be on call 24 hours a day, or they're choosing to practice either in a clinic or hospital setting — not both. They also may be less interested in starting their own practices, which requires the commitment of running both a practice and a business. Work-Life Balance While 'work-life balance' may be an overused term, Gen Z embraces the concept. 'I do think that there is a general momentum toward recognizing that better cared for physicians make for better cared for patients,' said Lena Volpe, MD, a second-year resident in Ob/Gyn at Northwestern Medicine in Chicago, who describes herself as 'in between a Millennial and Gen Z.' 'Every generation takes their own approach to the way they think will benefit patients most. The better we take care of doctors and set expectations for physician wellness and physician burnout, the better we can care for patients,' said Volpe. 'This generation of doctors has recognized that physician burnout is a real problem, and Gen Z is focused on the solutions — not just a wellness retreat, yoga class, or pizza party, but how we can better structure our programs and change our expectations for what we will be as attending physicians and medical students.' These new doctors are also likely to embrace boundaries. 'Healthcare is 24/7, and people need healthcare around the clock — but Gen Z says, 'I'm going to protect this or that piece of my life,'' said McCloskey. 'They want to show up and care for patients and then go home…the thought is, 'I'm willing to go above and beyond at certain times, but I'm not willing to do it at the detriment of my personal life.'' Grace Akatsu, an MD/PhD student who just completed their third year of medical school and is starting a PhD program at the University of Colorado, Denver, thinks their generation is pushing for a greater boundary between work and personal life. 'I think in the past, a job like being a physician has been viewed more of a calling — an all-consuming entity without much room for anything else,' they said. 'Gen Z sees it more as an important part of your life, but not your entire life.' Emphasis on Technology Gen Z is also exceptionally conversant with technology. 'The way that my coresidents and medical students think about applying technology to medicine…there's an automatic assumption that tech will make it more thorough,' said Volpe. This generation isn't the first to innovate, of course, but the way they incorporate tech and mobile apps is different. 'We think about it from an efficiency standpoint. How can we take this process that's working but may be inefficient and make it better? With each generation, technology is more and more integrated into our lives, and we're catching up with that in our work,' Volpe added. This integration of technology can only improve medical care. Akatsu plans to study ovarian cancer as part of their PhD program. 'I'm using machine learning to pull together all this publicly available data for this kind of cancer,' they said. 'The availability of these computational tools to advance human health is incredibly exciting. There is so much potential as these technologies become even more accessible.' Challenge to Traditional Hierarchies This generation is also willing to push for change. 'I turned 18 in 2016, and every election I've voted in has been incredibly consequential,' said Akatsu. 'My whole young adulthood has been 'unprecedented times,' but they're not unprecedented times to me.' Gen Z has experienced huge upheavals in politics, health, and technology as young adults, they added. This generation's experiences can bring with them a sense of empowerment that these systems in healthcare are moldable and flawed. 'It is important — in a respectful and conscientious way — to try to push for change where needed, even if means pushing against the traditional hierarchies that can be baked into medicine,' said Akatsu. Medicine is already seeing this influence, added Volpe, citing residencies across the country that are starting to unionize. Greater Focus on Transparency, Personalized Medicine, and Mental Health Gen Z is also changing how doctors interact with patients, providing greater transparency and empowerment. 'I think we are supporting patients better in advocating for themselves,' said Volpe. 'For example, doctors and healthcare workers turn to social media to raise awareness about specific conditions and make information easier to find.' There's also a shift away from paternalism in medicine, adds Akatsu. 'Even 10 years ago, it was more common to tell a patient, 'You need this test,' and not necessarily elaborate more,' they said. 'Now there's more collaborating with the patient and participating in decision-making and info-sharing, like, 'Here's what I'm thinking. Let's work on building this relationship and this rapport so we can improve your health together. It's not just me giving you orders.'' In addition, Gen Z embraces the importance of mental health among both physicians and patients. 'I think my generation really made a breakthrough around decreasing the stigma around mental illness and seeking treatment for mental health,' Volpe said. 'Working 100 hours a week in residency is not conducive to mental health…especially in training. I do feel physicians and people in healthcare, my peers, understand mental health is a critical part of physical health.' Changing Values, Changing Medicine The newest generation of doctors seems to be affecting the culture of medicine and will likely continue to do so. 'I think something that sets Gen Z apart from all the other generations is that we are the most comfortable with change because it's all we have known as adults,' said Akatsu. 'I am sympathetic to the idea that change is scary and unsettling, but I hope we can empower our colleagues…to embrace change where needed.' Understanding the 'why' of Gen Z can only improve not only the medicine but also the relationships between docs of different ages, added McCloskey. 'I would love to see our doctors approach the generational differences with curiosity instead of criticism,' she said. 'We all need each other, and we can all learn from each other.'
