Medicine is turning into a day-job not a vocation

As older doctors retire, a new generation has arrived with different professional and personal priorities

Around the time of the appointment of the new Taoiseach Simon Harris much was made of his relative youth; at 37 he is the youngest person to hold the office. As someone who is only a few years younger, it made me think, after all these years at the metaphorical kids’ table, is my generation suddenly in charge?

The signs have been there for some time – our parents’ generation, the consultants and GPs who we grew up with and learnt from as medical students and junior doctors have all started to retire and a whole new crop of ‘young ones’ are on the scene. Not only are my peers in their 30s doing proper adult things like buying homes, getting married, and having babies, we’re now getting proper adult jobs like becoming consultants and GP partners too. 

Much has been made of the differences between our generations, between the attitudes of the ‘boomers’ in their 60s and their millennial offspring. It is true that younger doctors perceive their role very differently to those before them and this will have important consequences for workforce planning now and in the future.  

A recent ICGP survey of new graduates showed that new GPs are less inclined to work full-time and to enter into partnerships earlier on in their careers. They find the small business model of general practice unappealing and do not feel ready or empowered to take on the financial and managerial responsibilities of the traditional GP principal. They are more likely to be female and more likely to have caring responsibilities. They cite concerns around work-life balance and want more flexibility around their working hours.

I get the sense that my generation are more likely to see their role as a doctor as a day job rather than a vocation, a job that is one of many parts of their identity rather than the singular focus. GPs of previous eras were  used to working long hours into evenings and weekends and would have found it acceptable for patients to have their personal phone number or show up at the front door of their homes. This would be seen as anathema to most younger doctors now, who see the need for stronger boundaries between their work and home lives.

GPs of previous eras were used to working long hours into evenings and weekends and would have found it acceptable for patients to have their personal phone number or show up at
the front door of their homes

I’m sure that the older generations look down on us as dilettantes who are far less committed to medicine and our patients than they were. I would argue that this is a much healthier approach to work – to give it your all for the time you are there and then close the door on it at the end of the day and go home. Although what we do is valuable and the close relationships that we can develop with patients are hugely meaningful to both us and them, it is important to remember that they move on remarkably quickly without you and the world keeps turning as soon as we’re no longer there.

This new attitudinal change will require careful planning around how we going to design our healthcare service to the benefit of both its staff and patients. Contracts need to be designed with more flexible working hours and family-friendly policies. The postgraduate training bodies need to redouble their efforts on this and greater supports should be put in place for doctors as they establish their careers. The outdated GMS contract requires revision to meet the needs of both patients and their doctors. It should reflect the reality of the 21st Century rather than be allowed to continue to exist as a relic from the 1970s with multiple extensions and add-ons, which is the case currently.

Before I get too smug, it is important for me to remember that the generational march works both ways. Any time I meet medical students and patients in their 20s, so-called ‘Gen Z’, they seem impossibly young to me and their fashion choices incomprehensible. I am cringingly aware of how old and uncool I must sound when I try to talk to them as a peer. Although we are the ones rising through the ranks at the moment, in 10 or 15 years’ time they will be the ones coming through and we millennials will be the ones who will be seen as middle-aged and hopelessly past it.