The Dark Side of Doctoring

I do think the increasing corporatization of medicine in the USA has accelerated the loss of autonomy and satisfaction, which makes the abuse and overwork far more difficult to take.

There's no law that says private hospitals can't fund residency slots - in fact they fund many of them - but, as the source you're commenting on says; "[medicare is] the principal source of residency funding".

Yeah?

I just recently had a friend completely burn out of medicine, sell his house, and start traveling the world. He was brilliant, a good doctor, a good person. It's a shame he's been driven out, and so many others.

I also recently had the experience of seeing a young doctor bright-eyed and busy-tailed treat me once, and then six months later see him again. The toll that those six months took on him was visible. He was just about haggard with the work. It's easy to imagine he won't last long.

I feel there's an interesting parallel with teaching. Teaching and medicine both have licensure requirements, both have a strong appeal to people who care and want to make a difference in the lives of children/patients. And in both cases the profession is gradually being taken over by administrators and subject to increasingly onerous regulations.

I also recently had a friend burn out of teaching. She's set to work in a completely unrelated industry now. She put up with crap for a long time due to her care for the children, but at last she couldn't take it.

My libertarian side says these are two improperly functioning markets, with massive human casualties. It's a shame.

That being said, it's a difficult profession. Not a lot of people want to do it. Even fewer in such specialised positions as surgery, where mistakes literally cost people lives. There's no rolling back to a previous release or taking a break. Everything that happens, happen on that table with that body open.

Tack on the insane costs, at least in America, for going to school to be a doctor and you also have a situation where few people feel they can afford to be GPs (even though that might be what they really want to be; and the world needs more GPs desperately) and you also have doctors who are now locked into a profession to simply paid their debts.

> I just recently had a friend completely burn out of medicine, sell his house, and start traveling the world.

I don't think this is a bad thing. Everyone who can afford to should really save up and take a sabbatical every few years: http://khanism.org/perspective/minimalism/

While Medicare covers almost all of it, it became so nauseating to read the outrageous EOB totals that I tried to put a end to it - I requested that unless the on call nurse (after hours) or physician (during business hours) deems the fall to be a life threatening emergency, they are to be kept in the facility.

They found a workaround for that real quick - it's nearly always deemed life threatening because they are 1) unable to determine internal bleeding 2) unable to determine if a bone was fractured/broken.

The obvious solution to this is to have an xray machine on site, because since everyone in the chain gets paid huge $, and it removes the liability from the nursing home to ship them off to the hospital, the merry-go-round of insanity continues. We have two family members in an assisted care facility for almost eight years now, and between the two of them, they've tapped Medicare for just under $700K. Together, the sum of both their incomes throughout their entire working lives never totaled that amount. This is why I call it a ponzi scheme.