Physicians have become marginalized. Here's how young physicians can change this. 

Harry Severance, MD, adjunct assistant professor at Durham, N.C.-based Duke University School of Medicine, joined Becker's to discuss what young physicians need to know. 

Editor's note: This response was edited lightly for clarity and length. 

Question: What's something all young physicians should know? 

Dr. Harry Severance: One critical element, beyond clinical knowledge, that young physicians should now know and become involved in is the economic/political side of healthcare —  evolving economic business conditions and political decision-making realities driving healthcare and how these will affect the future of healthcare platforms and thus their careers. 

This is critical information whether one plans on becoming an employed physician, desires to open/manage their own private practice or envisions a role in physician leadership. Most physicians, for too long, have abrogated the business and political side of healthcare to others — trusting that these others would do the right thing for patients and the healthcare system — (I'll just see the patients and you manage the shop). This abrogation has led to marginalization of physicians as healthcare decision-makers and leaders while significantly contributing to disintegrating conditions within healthcare workplaces, leading to worsening patient outcomes, increasing worker departures from healthcare as well as other cascading workplace problems. 

Also, during this time we have seen an exponential explosion in the number of healthcare administrators/managers. These increasingly large cliques of manager/administrators now more frequently view physicians as an oppositional force. We have seen accelerating consolidations within healthcare systems, with many hospitals and healthcare facilities now part of megasystems dominated by corporate or private equity interests, who have increasingly imported senior decision-makers and managing board members from other successful nonmedical business sectors. But, said leader-imports increasingly have no clinical background. As physicians have abrogated their roles in business leadership positions, these boards now have little to no input from practicing clinicians and do not seek such input. Healthcare is increasingly being run as a business for business's sake, with profit as a sentinel driving force. 

Thus, young physicians, if they want to experience an enjoyable and long/prosperous healthcare work career, must become familiar with the economic and political realities of the healthcare workplace, inculcate that knowledge base into their practicing skill set, and actively strive to improve these conditions — no longer abrogating these issues to others.

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