Rehabilitation Institute Amy Houtrow, MD, PhD, MPH Gen X All the Way!!

Rehabilitation Institute The Changing Health Care System  Loss of the solo practitioner  Declining revenue from Fee for Service  Electronic health record  The rising cost of getting a medical education  80 hour work week

Rehabilitation Institute The Solo Practitioner  Working for the ‘Man’

Rehabilitation Institute The Solo Practitioner  Working for the ‘Man’  In 2012 (data from the AMA) –18% in solo practice (down from 40% in 1996) –29% worked for a hospital –53% physician owned practices  But 75% of estimated new hires in 2014 will join hospital based groups –Harder and harder to make a living in solo practice –Medicine is not entrepreneurial

Rehabilitation Institute Making a Living  The Golden Era of Medicine –Fee for service –Not a lot of paperwork –Made a good living, worked harder, made more  Now? Not so much –Costs more to run an office –Barriers to working smarter 43 min/day interacting with health plans

Rehabilitation Institute Electronic Health Record

Rehabilitation Institute Cost of a Medical Education  Medical school ~$50,000 per year –15,360 hours  Residents make ~$40,000 per year –30,000 hours  After training ~50+ hours a week  Adjusted wage of $35/hr

Rehabilitation Institute 80 Hour Work Week

Rehabilitation Institute 80 Hour Work Week 28 studies found no improvement

Rehabilitation Institute Values of Gen Y in Relation to Health Care  Life work balance  Sharing of household responsibilities  Privacy?  Compensation –Not so secretive –Not just about the dollars

Rehabilitation Institute Crossing the Generational Chasm  A super fun exercise!!  Collaborate professionally –Opportunities to develop professionally  Recruitment –Recruiting –Being Recruited