Generation Gap: Combating “fogeyphobia” in the workplace

In an address to the 2009 Combined Otolaryngological Spring Meetings in Las Vegas, neurosurgeon Harry Van Loveren, MD, chair of the department of neurosurgery at the University of South Florida, coined the term “fogeyphobia” to describe a tendency among older doctors to become reluctant to speak out against new surgical tools and techniques, out of fear of being viewed as old-fashioned.

So does the phenomenon extend to otolaryngology?

“The problem is that all that is new is not necessarily good,” said Paul Levine, MD, Robert W. Cantrell Professor and chair of otolaryngology at the University of Virginia Health System. “There are questions about the proper handling of newer techniques, so that patients are made fully aware if they haven’t been totally proven. Also, very heavy advertising for newer techniques is focused toward the consumer, and that probably makes some of the senior surgeons uncomfortable.”

But are some physicians reluctant to speak out? “I’m certainly not!” Dr. Levine declared. Indeed, he raised questions of his own about current advances in head and neck cancer surgery in his Ogura Lecture at the Triological Society’s 2008 Annual Meeting: “Would Dr. Ogura approve of endoscopic resection of esthesioneuroblastomas?”

When Newer Isn’t Better

Patrick Antonelli, MD, who chairs the department of otolaryngology at the University of Florida College of Medicine, noted that in his experience, senior surgeons have stayed in touch with current technologies and “embrace what’s new and good.”

Among his faculty are the original founding member of the department, George Singleton, now 84, and Nicholas J. Cassisi, who followed Dr. Singleton as chair. “[Dr.] Singleton goes to the spring meetings of the academy and sits up front to learn about the newer technologies,” Dr. Antonelli said. “He doesn’t operate any more, but he has pretty sharp insight as to whether these things are truly a step ahead.”

Dr. Antonelli added: “There certainly are individuals who may not have been as aggressive about keeping their skills sharp, but that’s not been my experience here.”

Senior surgeons have stayed in touch with current technologies and “embrace what’s new and good.”
—Patrick Antonelli, MD

Dr. Antonelli’s senior surgeons are more than willing to make their voices heard, he said. “Sometimes they’ll comment on something: ‘Hey, we tried that 20 or 30 years ago and it didn’t work. Even though it’s a fad now, it’s not going to be any better than it was back then,’” he recalled. “While it wouldn’t surprise me if they weren’t a little reluctant to speak about certain things, in areas where they feel comfortable, where they’ve seen fads come and go, they continue to be vocal and be respected.”