In contrast to the majority of physicians now in practice, those individuals now in medical school are being trained under different circumstances, and with different expectations. To begin with, they are now beginning to see patients, and even touch patients, earlier and earlier in their training—this, the result of the realization that too many people were in the past entering their residencies with only an abstract sense of what medicine was about, and lacking a strong enough sense of the connection between the anatomy and humanity of their first patients.
What’s more, most medical students are going to end up doing their residencies in geographical areas that are at least beginning to experience physician shortages; so even from the get-go, they will be managing very full patient-visit schedules if they enter private practice. In some markets and communities, the shortages in certain specialties are already reaching major proportions; and in Massachusetts, where statewide healthcare reform has already been effect for a few years now, there are severe shortages and long wait times to get doctor visit appointments.
Finally, a solid majority of medical students are working with and on clinical information systems as they enter their residencies. Now, here’s where things get really interesting, because many medical students considering residency opportunities are turning away from hospital organizations that haven’t yet fully implemented EMR and CPOE systems.
So it’s important to consider that factor in planning for the future. After all, 10 years from now, most of the 60-year-old doctors will have retired, and most of the 50-year-old doctors will be contemplating retirement. Meanwhile, there will be a horde of 30-something doctors to think about. And these will be doctors who grew up on Facebook, MySpace, Twitter, and texting.
On one level, this is self-evident, of course. But it’s natural to be thinking about one’s largest (and sometimes loudest, to be honest!) cohort of current end-users. The reality, though, is that the world is changing quickly, and the physicians who will be the major cohort of end-users in most hospital organizations in the next 10 years will consider it unacceptable to have to work in paper-based systems. Expect them to be pushing forward in every area of clinical computing, in contrast to some of their elders of just a few years ago, who were being dragged kicking and screaming into the electronic world. What’s more, for a period of at least several years, everyone in IT will feel like that classic “sandwich generation” so remarked upon by sociologists—middle-aged people with aging parents and young, growing children. It’s far from ideal, but it is the reality, and will be for some time to come.