It may be difficult to admit, but aging is inevitable, and while many emergency physicians were once fresh-faced and bright-eyed with an expeditious gait, their faces now bear wrinkles and their walks lack the urgency of days past.
Those words, from the always-candid Gregory Henry, MD, may be tough to hear, and it may be even more difficult to admit that a 12-hour shift is not as easy as it was at 30, he said.
No one wants to acknowledge this, said Dr. Henry, a clinical professor of emergency medicine at the University of Michigan Medical School, in his lecture at the recent American College of Emergency Physicians Scientific Assembly. But he said many EPs should probably work less shifts. Eventually, we all must, he said, and it is necessary to be prepared for it before that time comes.
“At a certain point our productivity does change, and [we] probably ought to take less money,” Dr. Henry said. “So what? When you get to be my age, how many more sets of dishes do you need? The bottom line is we need to look at this curve situation for a lot of reasons. Maybe you will make less money next year, be slightly less productive, but you're still in the game.”
While productivity may decrease, the skills a doctor develops over the course of a career are still valuable. It is about figuring out where you see yourself at an older age, Dr. Henry said.
“You take a long time to develop great skills, but you rarely take the time to ask yourself how this becomes a launching pad for the next logical step in [your] career,” he said. “Start with the end in mind. Lay out what you think you're going to be doing five, 10, 15, 20, 30 years from now. You're young and beautiful now, but there is going to be a time when you are 65. I promise you that.”
In creating a plan and preparing for the certainty of aging, a doctor can explore the numerous ways he can continue-treating patients but practice in a way that best suits his-physical ability. “This is the first year I am not seeing patients,” Dr. Henry said. “People come to me and say, how do you like retirement? I want to wring their necks. I did not retire. I refocused! You refocus your energy to what's age appropriate.”
First on the agenda: shift length, which Dr. Henry said has to be analyzed by older physicians. Shorter shifts are obviously better, he said. “Every group that I work with has come to the reality that [doctors] should start out when [they're] young working more bad shifts, night shifts, and then as [they] get to around 55, trail those bad shifts off because your brain handles it better when you're young than when you're old,” Dr. Henry said.
He also urged older physicians to supplant some of their emergency medicine work with urgent care, where there is a need for judgment and experience.
“There's nothing wrong with urgent care centers,” Dr. Henry said. “There are so many opportunities out there that are less wearing on your body. You can contribute in a lot of ways and at a lot of levels. Use your degree. It's worth it.”
Another good way to use experience and knowledge is to teach, which can keep any older physician feeling young. “Feed off the excitement of the young,” Dr. Henry said. “You're only as old as those you inspire. There is not a better feeling than after you've entertained residents for two hours.”
Dr. Henry also advised doctors not to blacklist words like “administration” and “medical politics” because these areas are necessary in today's age, and it's always better if doctors fill these positions and get involved. It all comes down to doing what you love, and for emergency physicians, that is-continuing to be stimulated by the job.
“The single largest problem in groups today is what you are going to do with the old,” Dr. Henry said. “What's going to happen to these folks? Why is this the issue? The meaning of life is being able to spend time doing things you love with those you love to do [them] with. The day I'm not looking forward to is when the end committee calls and says, ‘Greg, we don't need you this year.'”