by Dr. Kenneth H. Cohn

The purpose of this post is to summarize conversations that I have had with three physicians this summer about healthcare reform. I feel blessed to have a group of friends from medical school who rent a house on Cape Cod every July and to their spouses for making it happen.

As baby boomers who still view the practice of medicine as a calling, we recognize that many Gen-Xers do not see the world the same way.

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As an instructor for the seminar Non-Clinical Careers for Physicians, I can attest that the majority of attendees are Gen-Xers, who are looking for opportunities that provide intellectual stimulation and work-life balance.

A medical school classmate practicing in Pennsylvania asked me to recommend any gastroenterologist that I met during my travels to him because, with two partners contemplating retirement, his group has been looking for more than a year for replacements. "People finishing fellowships want the security and predictability of hospital or healthcare-system employment; they just see the downside of independent group practice and none of the advantages," he said. "I feel like a dinosaur.”

An infectious disease specialist from New York, who prides himself on performing meticulous histories and physical examinations, concurred that the residents with whom he works are much more time-delimited in their goals. He decried electronic medical records that lead to "vacuous notes and the propagation of misinformation" as a result of mindless copying and pasting.

An oncologist living in Florida commented that nobody is talking about the downside of the resident work-hour rules that decrease continuity of care by physicians who know their patients.

Chris Cornue, in The Power of Trust, quoted Dr. Steven Covey, who said that reestablishing trust across the industry will be a key piece of changing healthcare going forward. Trust increases the speed at which reforms can proceed and decreases their cost.

The challenge of any meaningful healthcare reform efforts is the extent to which they engage healthcare professionals to make a difference in patients' and families' lives. In Collaborative Listening, I mentioned Brian Wong's survey of over 1,500 practicing physicians (A Prescription for Physician Reengagement. Futurescan 2009:23-26) that the majority of physicians seek:

• Meaningful work that makes a difference in patients' lives.
• A sense of community.
• Regular, reliable and positive feedback that affirms their value.

What do you think?

• What conversations about the uncertainty of healthcare reform efforts have you been having with your physicians?
• What are their concerns?
• How, as Chris Cornue talked about, can we reestablish trust?

I welcome your input.

Ken is a practicing general surgeon/MBA who divides his time between providing general surgical coverage and speaking, writing, teaching and consulting on physician-hospital relations. Learn more about what he does by visiting http://healthcarecollaboration.com.