Millennials in medicine: doctors of the future | Daniel Wozniczka | TEDxNorthwesternU

Millennials are contributing a lot to the world, and we're not just talking about Instagram photos of coffee. Dr. Daniel Wozniczka talks on how millennials are the key to the future of a better world for medicine.

Dr. Daniel Wozniczka, M.D., is a Chicago physician with a passion for creating real world solutions which improve healthcare for both patients and physicians. Along with practicing medicine, he is currently completing his MBA and MPH degrees at the University of Illinois at Chicago. He believes the upcoming generation of physicians will completely revolutionize medicine as a whole both locally and globally. He has firsthand healthcare experience not only in Chicago, but also in Sub Saharan African, Eastern Europe, and Southeast Asia.

This talk was given at a TEDx event using the TED conference format but independently organized by a local community. Learn more at https://www.ted.com/tedx

I have a confession to make.

For years now, I've had
this deep, dark secret -

my whole life, really -

that I've never told anybody.

But here and now,

I think I'm ready to tell the world.

So here goes:

My confession is that I am

a millennial.

I know, it's terrible.

That's the worst.

What was I thinking when I decided
to become a millennial, right?

(Laughter)

I feel better already
just having told you guys that.

You know, millennials
were a cohort of people

born from the early or middle 1980s
up until about the early 2000s,

but that definition is pretty much
the only thing that's agreed upon

for our generation.

Nevertheless, you guys have probably heard

a lot of negative thoughts
and stereotypes about us.

You might have heard
we're narcissistic or entitled,

that we're lazy and unfocused,

that we're addicted to our telephones
and obsessed with Instagram filters.

Now, some of that may be true,

but you don't really hear
about the positives too much.

As we all know, stereotypes don't tell
a whole story about a person,

let alone a whole generation of millions.

So, that being said, allow me
to actually introduce myself formally.

My name is Dr. Daniel Wozniczka.

My patients just call me Dr. Dan.

That's what happens when you have
a hard-to-pronounce Polish last name.

I'm 29 years old,

and in a few days, I'll be finishing
my internal medicine residency.

I'm also finishing two master's degrees,

one in business, my MBA,

and one in public health, my MPH.

I'm also a medical researcher.

I've published in
some peer-reviewed journals.

And outside of medicine,
I do a little bit as an entrepreneur.

I'm either the founder or expert advisor

for a couple different
healthcare start-ups.

Last but not least, I've worked
as a congressional lobbyist,

which is pretty much exactly
what you think it is,

on behalf of ACP,

the American College of Physicians.

They've sent me down to Washington, DC,

and I've chatted
with congressmen or senators

about different healthcare issues.

I bring all this up because
some of what I'm doing,

it really brings to light the positives
of our generation as a whole.

For example, the millennials

are the most educated generation
we've ever had in America.

We're also the most diverse
that this nation's ever seen.

Unsurprisingly, we're
the most tech-savvy, also.

But there's one particular
positive attribute

that no one really talks about.

It pertains to the workforce.

You can ask millennials
a very simple question:

"What do you want
to accomplish in your career?"

They'll give you an answer
that may seem simple,

but it's profound.

They'll all tell you
how they want to make an impact.

They want to change the world,
they want to innovate.

And what a beautiful mentality that is
when you start your career.

So as we go forward,

this impact will drive forward
the millennials.

People always ask me,

"What's it like to be a doctor?"

I always give them the same exact answer:

I love medicine!

Couldn't do anything else.

I was that guy in kindergarten
who knew he was going to be a doctor.

I want to tell you guys a story
about why I love medicine so much.

A few weeks ago,

a patient comes into my hospital,

really sick.

He's got an infection
in both of his lungs.

That infection has spread
to his bloodstream,

so he's sick all over.

He has something called septic shock.

His breathing is so bad
that the only way he can get oxygen

is if we put a tube down his mouth,
through his throat, into his lungs

so a machine can breathe for him.

His blood pressure starts to plummet.

A healthy blood pressure is like 120/80;

this guy is 50/30 and dropping further.

I have to put a medicine
called a vasopressor

to bring his pressure back up.

For that, I've got to put a catheter
into his jugular vein,

push it further into his subclavian

and even further
towards the edge of his heart.

Doesn't work that well, though;
his pressure keeps on dropping.

Before my very eyes,
his heart stops beating.

He passes away.

We don't stop, though.

One of my nurses literally jumps
on top of the guy

and starts pressing onto his chest.

We get a crash cart,

we take these two paddles,

charge them up
to 600 volts of electricity,

put it on his chest,

and just like you see on television,

we shock him.

It works.

His heart starts to beat again.

We literally brought him
back from the dead.

A few weeks after that, this same guy?

His youngest daughter is getting married,

and he's able to walk her
down the aisle on her wedding day.

I love medicine for things like that.

I've only been a doctor for three years,

but I've got hundreds
of those stories already.

But even though I love medicine,

I don't really love my job.

I know that sounds like a contradiction,

but it's not.

No one really talks about what really goes
into the day-to-day work of a doctor

and how much of it has absolutely nothing
to do with medicine.

For example,

I spend hours a day, any given day,
filling out paperwork and forms.

For every hour
I'll take care of a patient,

I'll spend two hours filling out forms.

The reason for that is pretty simple:

those forms get submitted
to an insurance company,

and it's based on those forms

that the insurance company
will reimburse the hospital,

will pay them.

And it doesn't really matter how great
of a job you did on that patient;

if that form isn't
filled out meticulously,

with all the details needed,

the hospital gets reimbursed less,

if at all.

Hours of my day on forms.

But then there's that last part of my job
that's probably the worst.

After I've diagnosed my patient,
after I treat them,

then I have to navigate
insurance companies

to make sure that my patients
get the medicine they need.

As we all know, patients
that can't afford their medicine,

that's a patient that's not
going to take his medicine.

It breaks my heart, guys.

I've got patients coming
to me in the hospital

for a second, third,
fourth, fifth, sixth time

for the same exact thing

simply because they can't get their pills.

And it's not just pills, too;

I have to spend hours figuring out
which surgeon I can send my patient to,

or which dialysis center,
which nursing home.

Hours of my day.

That's what it's really like
to be a doctor these days, guys.

On the national level,
things get even more complicated, though.

All these slides we're about to see
are from the Kaiser Family Foundation.

The amount that we as a nation pay per GDP
for all healthcare is astronomical,

higher than any other country.

And what we get from it,
not only is it not better,

it's sometimes worse.

You might be saying to yourself
that this has always been this way, right?

That's the American system.

No, not really.

Because, you see, as late as the 1980s,

what we were paying was on par
with Canada, with the UK, with Europe.

It's only recently that these man-made
systems have changed it.

The future, sadly, as you can see here -

even more bleak.

In the decades to come,

what our nation will pay
for Medicare expenditures

is going to skyrocket.

It could virtually bankrupt
the entire nation.

Now, all of these things,
all of these pressures,

both on the day-to-day,
personal-level doctor

as well as on the national,

they make things
more stressful for doctors

in a job that's already stressful -

you're literally doing
life-and-death decisions.

So these new pressures,

whether it be new quality metrics

or doctors being told
to see more patients in less time,

spending more time to fill out forms -

surgeons are being told,

"Hey buddy, you've got to hurry up
those operations,

squeeze in a few more cases."

All these things come at a cost,

and I don't mean financial.

Right now, we have an epidemic
of physicians committing suicide.

Every single year in America,
we lose between 300 to 400 doctors

who take their own life.

That's a doctor a day, on average.

That's an entire graduating
medical school class gone,

every year.

No one talks about this, though.

Who's most at risk?

It's the female doctor.

A female doctor is 2.3 times
more likely to commit suicide

than a female in the general population.

That's medicine these days, guys.

There was a great, great study
published in Medscape in 2012.

They asked 24,000 doctors
a simple question:

"If you could go back in time
and change careers,

knowing then what you know now,

would you still choose medicine?

Or would you do something else?"

You guys know the results?

Fifty-four percent of doctors
said they would stick with medicine.

Half of us either can't
or don't want to do this anymore.

That's the sad truth
that no one talks about.

So, where do we go from here?

What are the millennials,

what's a 29-year-old doctor
in Chicago, just starting out,

going to do?

The answer I have for you is both
incredibly simple and very complex.

We fight the system.

We fight the system for ourselves,
for our families, for our patients,

for the generations yet to come.

And I want to tell you guys
exactly how we're going to be doing this.

We here in this room,

we probably wouldn't think
of a hospital as a business, right?

Well, rest assured,

in our capitalistic society,
there's a lot of people who do just that.

Every business needs a boss, needs a CEO.

What would you guys think
of a basketball coach

that never took a jump shot in his life?

What about a principal
that never taught a classroom?

What about an automobile CEO
that doesn't know how to drive a car?

I mean, I'd have low expectations
for all of these people, right?

But that's what we've been
doing for decades.

The people who are running our hospitals
know nothing about medicine.

They run it as an old-fashioned business,

looking at Excel spreadsheets,
maximizing profits.

There was a study that compared this,

published in the journal
Social Science & Medicine, 2011.

They compared all the hospitals
that were run by a normal businessman

as opposed to the couple
that were actually run by doctors

who had some business training.

The hospitals that were run by doctors,

in almost every single
quality metric we had,

whether it be cost of care,
medical errors, length of stay,

what have you,

in almost all the metrics,

they outperformed the other hospital
by 25 percent or more.

Shocking, right?

No, not really, but that's what
we've been doing for decades.

On the national level, it gets even worse.

The people writing our healthcare laws,
our policy, they're not doctors either.

We've got 435 people
in the House of Representatives,

and we've got 100 in the Senate.

535 total.

Would you believe me if I told you

that only 3% of our elected officials
are doctors or scientists?

But these are the people making our laws,

despite the fact that we know
how contentious a thing healthcare is,

the past few decades.

That impact that I mentioned
the millennials making,

that aspiration to change the world?

It's not going to be coming
with medicine itself.

It's going to be coming
in the system that we have.

Right now, we have the revolution
of the business-trained doctor,

the rise of the MD/MBA.

Fifteen years ago,

we had 30 medical schools
who offered a joint MD/MBA degree.

Nowadays?

It's doubled to 65.

The reason is obvious:

medical schools know

that we don't have to just train
new soldiers to be in the trenches;

we have to train brand-new generals.

Going forward, that impact
the millennials will be making

will be to take over
hospital administration,

to run hospitals,

to go into medical entrepreneurship,

to go into politics and make laws
that actually make sense for our country

and don't bankrupt us.

That is how the upcoming generation
of doctors will change healthcare.

They'll be saving lives
and saving healthcare itself.

I want to end by talking to some
of the younger millennials directly

because yeah, I'm a millennial, I'm 29,

but I'm on the older side.

And, you know, I'm finishing
residency in a few days

and I'm finishing my MBA and my MPH.

A lot of the millennials
that might be watching this,

they're probably 18, 19, 20 still.

And if you're that young
and you want to be a doctor,

you've still got a lot of years
of training and education ahead of you.

Four years of college,
four years of medical school,

and at least three years of residency.

I want to speak directly
to you for a second.

Because you're going to hear
the older generation tell you,

"Medicine's not worth it.

Don't become a doctor.

Medicine's changed, guys."

You're going to hear that.

I'm here to tell you the opposite.

Medicine is freaking awesome, alright?

Nobody has a better gig

than the guy who devotes his life
to saving the life of his fellow man,

I promise you.

I don't care if you're climbing
to the top of mountains

or diving to the bottom of the ocean,

I don't care if you're a rockstar
selling out concerts coast to coast.

I don't even care if you're an astronaut
going to outer space.

Nobody has a better job
than the person devoted to saving lives.

We need young, talented, inspired,
creative minds to come into medicine,

not to be dissuaded away from it.

And what a beautiful time
it is to come in,

because we will be
that generation that changes it,

that improves the system.

The problems we have in medicine
are not intrinsic to patient care;

they're man-made systems
from past generations.

Don't let anyone dissuade you away
from your dream of becoming a doctor.

I want to end with this quote.

This is a quote that's inspired me

through a lot of all-nighters
in med school.

It's inspired me through a lot
of 24-hour shifts in my residency,

and I hope it'll continue to inspire me

as I strive to make that impact
that my generation so hopes to make.

The quote is this:

"Those of us that are crazy enough
to think we can change the world,

we're the only ones that stand a chance
of actually doing it."

Thanks so much, guys.

(Applause)