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“It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has.” - Sir William Osler

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    Tuesday, June 01, 2004
    Old Guard Vs. New Guard

    A couple weeks ago The Firm held one of its quarterly partners' meetings. These meetings are generally long and dull, as I suppose the meetings of most businesses are. They are enlivened in the first half hour by the serving of dinner ("Pollo Loco again?")and by the chance to chat with one's fellow MDs. The Firm is pretty big, and our members are spread among four or five different offices, so in many cases we only get the chance to talk in person at one of these meetings.

    At this particular meeting an issue came up which illustrated - to me, anyway - the changes taking place in medical culture. The topic at hand was partnership. To be more specific, a doctor who has been with us for two years (the traditional length of time before a member qualifies) was under discussion for possible partnership. She works hard, is respected by all the MD's in her office, and is committed to the group. The problem is, she works part-time (though more than 50%) and no one in the history of The Firm has ever been admitted to partnership without working full-time for at least two years. We have several doctors who work part-time, mind you, but all of them worked full-time for years before switching. Thus the debate: could anyone not working full-time even be considered for partnership? Forget prorating benefits, forget her skills or commitment. Would The Firm even be willing to consider a part-timer as a partner?

    Three of the senior docs (all male) immediately voted no. They gave various reasons but they all boiled down to a variant on "Can we rely on anyone who isn't willing to commit fully to the group? Do you realize this means that someone working part-time might then qualify to be a member of the board of directors?" (because any partner can run for the board).

    You could feel the atmosphere change in the room. Every woman sat a little straighter. All the part-time doctors in the group are female, and they all have kids - this is of course their whole rationale behind working part-time. Hands started going up. "How are we supposed to attract women physicians if we aren't willing to take part-time MDs as partners? You know the demand for female physicians these days, and let's face it, most of them are going to have kids. We've got to do this."

    I'll spare you the rest of the debate. Suffice to say that the Old Guard was voted down in a landslide. They looked somewhat taken aback but accepted the situation with good grace. There are lots of details still to be thrashed out, but it looks as if the old mindset of "Forget about your family, Medicine comes first" is changing.

    The following week I was chatting with V. and told her about the events of the partners' meeting (she'd missed it, being on vacation). Specifically, I told her about Dr. X, one of the old-timers who'd led the Old Guard in arguing against granting part-time docs partnership. Her response was succinct:

    "Who raised his kids?"



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