August 26 2018
by Neel Desai, M.D.
Dr. Joshua J. Goldman is an Integrated Craniomaxillofacial and Microsurgery Fellow at Beaumont Hospital in Royal Oak, Michigan. He completed his residency in Integrated Plastic and Reconstructive Surgery at the University of Nevada Las Vegas School of Medicine and graduated from Texas Tech University Health Sciences Center School of Medicine.
Dr Goldman has a passion for writing and is a 2018-19 Doximity Fellow in the Authors Program. His writing critiques the medical education system, as well as flaws in the current healthcare system at-large. Dr. Goldman’s combined skills, talents, and passions led him to a unique path in medicine:
“It’s my passion for healthcare, my esteem for physicians, and my regard for the patients we aim to serve, that drives my interest in improving it. My fellowship is the first of its kind and integrates microsurgical skills into complex adult and pediatric craniofacial pathology ranging from congenital syndromes to post-cancer and post-trauma reconstruction.”
“My plan is to build a career in academia, contributing to the scientific collective through clinical research and surgical device innovation, providing direct patient care and international volunteerism, teaching and advancing medical education, writing, and advocating on behalf of physicians’ and patients’ well being.”
He recently published a series in Doximity in which he noted the next generation of physicians questioning why things are being done the way they are and why doctors have let this happen. Adapted from The Emperor Has No Scrubs: The Rise of Millennials, The Fall of Hierarchy, Part III of the Residentured Servitude Series:
“Whether you want to classify them as millennials or demean them as snowflakes, there is a palpable change in the attitude of incoming medical students and residents. I can only speak from personal experience and that of many discussions with peers and colleagues, but there is an unprecedented sense of entitlement based on prior accomplishment, or sometimes just potential, and an unwillingness to “pay dues” simply because their bosses did before them.”
“They pay limited, if any, heed to tenure and offer minimal deference to title. They truly do not care if you hiked uphill, both directions, in the snow. In fact, they want to know why you chose not to reverse commute and walk downhill both ways or why you did not simply build a tunnel through the snow, whichever is more cost-effective.”
“In a society that swiftly traded a “time-served” promotion system and reward model, for one of “value-added,” who can blame them. Medicine has lagged in this respect and many others. (Adapted from The Emperor Has No Scrubs: The Rise of Millennials, The Fall of Hierarchy, Part III of the Residentured Servitude Series)“
Dr. Goldman goes on to highlight a monumental paradigm shift in the next generation of physicians’ mindset. He describes what this means for the current system and how more senior physicians can adapt to these cultural shifts:
“The healthcare system perceives residents as fortunate to have a training spot, and treats them as such. But what happens when the incoming trainees begin to believe they deserve, or are owed, that spot? If indentured servitude hinges on the servants’ reliance on their position for ultimate survival, what happens when all-of-a-sudden their opportunities exponentially expand?
Perhaps you find that the emperor has no scrubs, and the hierarchy suffers or collapses altogether.
Either way, young physicians are jumping ship for non-clinical or clinic-adjacent roles, or, they are staying and, for better or worse, challenging centuries-old training paradigms. Established physicians have found threats to the status quo off-putting, and have condemned them in under-their-breath grumbles and outwardly expressed misgivings. Their concerns are justified, but I remain cautiously optimistic. My recommendation is active understanding, guidance, and involvement in lieu of passive grumbling and complaining.”
It is clear that Dr. Goldman’s passion for changing medical education and the current broken healthcare system is having significant impacts. He has also been able to combine his passions, skillsets, and clinical interests to thrive in his unique space of medicine. It is our honor to recognize Dr. Joshua J. Goldman as our Medical Influencer of the Week.
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