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The Dark Side of Doctoring

ericlevi.com

21–30 of 241 posts

Re: The Dark Side of Doctoring

#21
It seems like we have an undersupply of physicians. My understanding is that the AMA limits medical school admissions[1] in order to keep salaries artificially high. This naturally leads to overwork in addition to high salaries.

[1] http://www.usatoday.com/news/health/2005-03-02-doctor-shorta...

Re: The Dark Side of Doctoring

#23

It seems like we have an undersupply of physicians. My understanding is that the AMA limits medical school admissions[1] in order to keep salaries artificially high. This naturally leads to overwork in addition to high salaries. [1] http://www.usatoday.com/news/health/2005-03-02-doctor-shorta...

Here's the go-to that I send people to when this comes up: https://skeptics.stackexchange.com/questions/4561/does-the-a...

Re: The Dark Side of Doctoring

#24
post #7

Where does the AMA stand on this?

They actively pursue minimizing the number of medical school seats and their lobbying has been tightly aligned with Republican health care policies for decades. Check out Paul Starr's The Social Transformation of American Medicine

Re: The Dark Side of Doctoring

#25

My wife is a medical resident and the issues described by this doctor are absolutely pervasive in residency. The strange part is, the overwork also seems to be pervasive among the attending physicians who have been out of residency for decades. Not just the residents. As a tech founder analyzing the system from the outside, I think this writer has nailed the core issue: "... a doctor is just one of the many commoditi…

Do you think if the United States graduated more doctors every year, it would prevent doctors as a group from being overworked and overtired? As a college student, I often wonder why pre-med is so academically competitive despite the fact that the ambition to help others is a virtue; and whether that competitiveness to get a high GPA and MCAT score is needed at all.

Re: The Dark Side of Doctoring

#26

The FAA enforces work limitations on pilots, but we schedule our health care workers like this? How are there not even civil cases against errors caused by this kind of administrative foolishness? Overworking doctors like this is insane.

The training for airline pilots is a lot less than for doctors.

A couple thousand hours of flying, many of which can be paid work (like flying an add banner).

Re: The Dark Side of Doctoring

#27
post #25

My wife is a medical resident and the issues described by this doctor are absolutely pervasive in residency. The strange part is, the overwork also seems to be pervasive among the attending physicians who have been out of residency for decades. Not just the residents. As a tech founder analyzing the system from the outside, I think this writer has nailed the core issue: "... a doctor is just one of the many commoditi…

Do you think if the United States graduated more doctors every year, it would prevent doctors as a group from being overworked and overtired? As a college student, I often wonder why pre-med is so academically competitive despite the fact that the ambition to help others is a virtue; and whether that competitiveness to get a high GPA and MCAT score is needed at all.

There has been angst about medical school admissions for decades. Med school admission really is the hurdle to get over in the US. There are more residency spots than US MD graduates to fill them. By a wide margin.

There's a strong medical education research unit in the UK (Edinburgh?); I remember one of their reports on a series of med student interviews making the observation that it was unnerving how the top performing medical students weren't the most compassionate, they were the most ruthless.

I'm taking my boards soon and I have to say, the ability to commit to the task, regardless of the emotions of your self, patients, peers, support staff, and family can definitely be an asset at times. Do I hope to take a kinder view when I start working in a few months? I'm not sure kinder would be the word. Supportive of a somewhat different set of ambitions, perhaps.

Unfortunately, that ability to deny the emotions of both self and other in pursuit of good clinical care is difficult to separate from 1) the punishment of self-loathing, and 2) the behavior of someone who has been rewarded too long for blind obedience.

Re: The Dark Side of Doctoring

#28

It seems like we have an undersupply of physicians. My understanding is that the AMA limits medical school admissions[1] in order to keep salaries artificially high. This naturally leads to overwork in addition to high salaries. [1] http://www.usatoday.com/news/health/2005-03-02-doctor-shorta...

Here's the go-to that I send people to when this comes up: https://skeptics.stackexchange.com/questions/4561/does-the-a...

The why is complicated, it seems obvious enough that more doctors would be a good thing.

Or at least, more practitioners. We don't need doctors with huge amounts of training to do every evaluation.

Re: The Dark Side of Doctoring

#29

It seems like we have an undersupply of physicians. My understanding is that the AMA limits medical school admissions[1] in order to keep salaries artificially high. This naturally leads to overwork in addition to high salaries. [1] http://www.usatoday.com/news/health/2005-03-02-doctor-shorta...

Here's the go-to that I send people to when this comes up: https://skeptics.stackexchange.com/questions/4561/does-the-a...

Unfortunately this didn't really clear up my confusion. In particular, the points brought up by the second answer there seem relatively unresolved. Why should DO graduates be growing significantly faster in number (proportionately) than MD graduates, when traditionally an MD degree is more desirable than a DO degree, despite both being mostly equivalent?

A few possible conclusions. I don't have enough knowledge to pick one. Some of my speculation might even be wrong.

(A) DOs and MDs filter through different or mostly different residency pipelines. Thus, residency limits for MDs don't affect DOs, so the DO population can grow more quickly.

(B) DOs and MDs do filter through mostly the same residency pipeline, and the increasing number of DO graduates is causing an increasing number of residency applicants to not be admitted to any residency program. (This malicious situation would be similar to the situation with law schools, which admit and graduate far more lawyers than the industry can possibly sustain and support in its current state.)

(C) There's enough non-government funding of residency slots that residencies are not as bottlenecked as the first answer claims. If so, this re-raises the question on whether MD admission is being rate-limited to increase scarcity and thus salaries.

(D) Perhaps something else I'm not thinking of.

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