In the second blog about my discussions with c-suite leaders in hospitals and large groups, one theme I pretty consistently hear is frustration with millennials.

They (and all generalizations here do not imply majority nor totality) want minimal to no call, generous guaranteed salaries, nominal work hours, ideal working conditions, and won’t take a position unless all those conditions are met. These employers are frustrated at what they see as a difficult group to hire.

Has limiting resident call hours, and eliminating the marathon life those of us pre-restrictions frankly adapted to and even reveled in (“Being on call every other night means you miss half the interesting patients”) created the new generation?

I don’t think entirely, because this generation is definitely different.

Technology and instant access to the world’s data is a game changer. A colleague after speaking to his children said, “This generation is different because they lived in the 9/11 era. Work hard, achieve success, and die when a plane crashes into your office. They want to live for today.”

Has restricted call hours improved patient safety? A systematic review of the effects of resident duty hour restrictions in surgery concluded that at least in surgery, there were no consistent improvements in resident well being, and negative impacts on patient outcomes and performance on certification examinations. At least in surgery, the overall effect seems to be negative.

The reasons are postulated to be a higher number of handoffs, resulting in poorer information transfer, less familiarity with the patient, and even fewer training hours resulting in less competent, though better rested residents. Extending residencies has been proposed as a solution.

So is it time to change the rules back? Reset? Medical school applications are at all time highs. That seemed to correlate (in my mind) to the restricted resident hours.

Applications rose when residencies became a bit easier. Would we lose a growing number of applicants by reinstituting the old work hours?

Would reinstituting no restrictions create more “old style docs” who worked till the patients were taken care of, and got used to or even enjoyed working long hours … physicians who felt that 80-hour weeks were a welcome break from the even longer weeks in residency?

Maybe it would. But I think not – at least not for this particular issue.

I do think it would improve patient care, training and performance on certifying exams. I hear that graduates who had limited work hours are not quite as competent on their own as those pre-restrictions.

The need for physicians will not go away anytime soon. The scarcity of physicians in a competitive market is going to allow physicians to demand more than is reasonable, and hospitals will continue to be constrained in what they can offer.

So how do hospitals, large groups and medical practices recruit millennial physicians? Others have some great suggestions. Here are mine:

• Firstly, if the first question is, “What’s the salary?” tell them you needn’t talk to them further, because if salary is the primary concern, that’s not the kind of physician you’re looking for. Then describe what you offer. And make it good, but not about the benefits, salary and vacation, because everyone offers competitive amounts of those, and make sure you’re at least in the ball park.
• Talk about your culture, your workplace, your level of engagement with your physicians, employed or independent, and how you look for active participants in your organizations’ success and goals, and mean it.
• Be honest and transparent about what you really want, and how you’re looking for someone who can make the vision come true. You may lose a few applicants, but you’ll keep the ones you really want.

Do you have any great suggestions for recruiting Millennials?