Generation Gap: Combating “fogeyphobia” in the workplace

Another senior surgeon who recently served on Dr. Antonelli’s faculty is Tom Herman, MD, now practicing at MacDill Air Force Base in Tampa, Fla. After 30 years in the field, Dr. Herman had retired and then, some years later, decided to return to practice by helping to start a new otolaryngology department at the base. Dr. Antonelli appointed him to his staff in order to get back up to speed on current approaches.

“It’s true that it can be very difficult for senior people to dispense with preconceptions,” Dr. Herman said. “But that’s what you have to do. There are times when I see people abandoning techniques that, in my hands, I always thought were effective. For example, I have no idea why certain types of intranasal surgery are done under general anesthesia today, when you can do it much more quickly with the patient awake.”

But, Dr. Herman noted, he doesn’t operate anymore. “Whatever I say is anecdotal, and I don’t walk the walk, so I don’t raise those questions. You have to understand that it’s a new world, and there are better resources that we didn’t have 20 or 30 years ago,” he said.

“An older surgeon who has traction in the community, experience in the field and is a recognized thought leader will speak out irrespective of what the reaction might be.”
—Gavin Setzen, MD

Setting the Tone

Several chairs of otolaryngology at major academic medical centers said that they take a conscious approach to ensuring that older surgeons feel comfortable speaking out within their departments.

Dr. Levine said it’s hard to stifle the opinions of a senior surgeon. “The tone has to be set by the chair,” he said. “It’s important that as the ‘leader of the pack,’ you create an opportunity for both sides of the coin to speak out.”

Kenneth Grundfast, MD, chair of otolaryngology at Boston University School of Medicine, agrees that the responsibility for combating any hint of “fogeyphobia” lies with the department chair. “It’s my responsibility to set a tone where that wouldn’t happen,” he said. “We have some very senior surgeons here, and I think that we’ve created an atmosphere where we appreciate their wisdom and experience,” he said. “We certainly know that there are some technical things that have come along that they’re not facile with, but we have created an atmosphere where they can share their wisdom without being characterized as antiquated. They’ve seen and handled situations that many of the younger people have only read about in textbooks.”