Baby boomer physicians often deride the fact that newly minted doctors want lives that are more balanced. Many older physicians still work Welby-style 70-to-80-hour weeks. White men dominated the profession in the 1970s. Fewer than 8 percent of physicians were women. Women now make up about half of incoming medical school classes. Research shows that they work fewer hours, largely because of family obligations.
Ripley Hollister, Colorado family physician and Physicians Foundation board member, said: “The older ones are being pushed out (of the system). Many are pissed off and leaving. They have a different view of medicine than the new ones. Being a doctor defined who they were. It was their purpose in life. Younger doctors work maybe 40 hours a week. They see it more as employment than a profession. They have a different view about quality of life. They won’t be quite the workforce (in quantity of hours).”
Darrell Kirch, president of the Association of American Medical Colleges, believes that new physicians have a more expansive view of medicine and life, and considers that a positive development.
“I see no evidence that indicates that their ethical commitment is any weaker, that they care any less for patients,” he told the Associated Press.
New Hampshire physician and Dartmouth Medical School professor Robert Wortmann wrote: “It’s a bit unfair to consider Generation X physicians to be unprofessional. Times change and so does our profession. Marcus Welby did not have a working wife, a computer, a preauthorization clerk in his office, or a utilization review committee in his hospital. When he started practice, there were only two nonsteroidal anti-inflammatory drugs available, and hypertension was not treated until it became symptomatic. Few hospitals had coronary-care units. Compared with today’s environment, he had so few tools to work with that his most valuable patient care resource was his time.”
In some ways, Welby was the predecessor of a concierge physician. He was available 24/7 and would spend as much time as the patient needed. Welby, of course, did not get a monthly retainer fee. In fact, he was quick to provide uncompensated care.
The spirit of Marcus Welby lives in today’s physicians. However, his business model is swiftly disappearing from the American landscape. Welby’s practice style could not survive financially in today’s medical culture: having to see one patient every 15 minutes to keep the practice open; seeking insurance preauthorization for treatment; and being office-bound.