As generational and demographic changes occur among health care professionals, the impact will be felt by everybody: administrators, clinicians, boards — and patients (which, let’s face it, means all us at some point or another). Recently, my longtime primary care physician announced he was hanging up his stethoscope. I was more alarmed than I should have been considering this piece I wrote a while back about a friend going through the same experience:
When Jack's doctor retired, he’d been seeing the guy for more than 20 years and had come to respect his skills and no-nonsense manner. "Many times when he'd walk into the room," Jack recalled, "he'd take one glance at me and growl, ‘Let's find out why you look like crap.'"
One day a few months ago, Jack, who turned 60 last year, woke up feeling lousy: shortness of breath, hacking cough, chills. He called the number he'd always called, made an appointment and showed up at the same medical office adjacent to his hospital.
This time when the door to the exam room opened, a lanky young man with a full head of blond hair and closely cropped beard strode in. "He was smiling from ear to ear," Jack told me. "Beaming." In the two and a half decades Jack had been going to Dr. Goodman, the physician never once so much as cracked a smile.
"He was stern," Jack said. “Gruff.” Jack liked that in his doctor.
"I'm Chace," the blond man cheerfully announced, and instead of shaking Jack's hand, patted him warmly on his upper arm. Jack tensed, fearing he would be pulled into one of those man hugs young people often inflict on one another these days.
"Nice to meet you, Dr. Chace," Jack said.
The young man laughed. "No, no, not Dr. Chace. Just Chace. I'll be your nurse practitioner."
Jack had heard of nurse practitioners. He had nothing against nurse practitioners. But he'd come there to see a doctor.
"Don't worry,” Chace assured him. “I actually went to school for this. I'll be examining you to find out just what's up. If you need one, I can even write you a prescription, believe it or not."
Jack’s inclination was toward the not. "This kid was half the age of any doctor I'd ever been to," he said. "He was half my age." Plus, he was male. Jack, of course, knew men could be nurses, but up to that very moment, he had never actually met a male nurse.
It also occurred to him that after all those years of going to Dr. Goodman, he couldn’t remember that doctor’s first name. "But," Jack said, "I'd be willing to bet money it isn't Chace."
As it turned out, the examination was like any other Jack had ever undergone, except that Chace talked more, laughed more and clicked away at the computer more. In the end, he made a diagnosis and prescribed a medication, and within a day or two, Jack felt good as new. Chace sent him an email immediately after the appointment with Jack’s personal medical record attached. A few days later, he called to make sure Jack was taking his medicine and it was having the desired effect.
Jack is well aware of how dramatically health care is changing. "I know that these changes are needed and that in the end it'll be good for patients and for the whole system," he said. "And I guess I'll even get used to seeing a nurse practitioner more often than a doctor. A really young nurse practitioner."
Jack’s experience — and now my own — is a reminder of how the transformation in health care is happening in many different ways. Baby boomers leaving the field and an aging patient population are two big ones. Adjusting is something all of us, inside and outside the profession, must do, however unsettling it might be.