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The Dark Side of Doctoring

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161–170 of 241 posts

Re: The Dark Side of Doctoring

#161

Post by erikb »

Life gets harder the more we dive into the financial crisis. Blue collar workers sometimes don't even get a job anymore, or work 3 at the same time just to pay rent. White collar workers work themselves to death in one job, although I have to admit it's maybe only 80% as harsh for IT as in medical. Even the rich that we all complain about lose more and more control over their money and their investments. We just don't like to see that, since who wants to admit that someone above oneself in the foodchain may also be struggling? Then we would also need to admit that the dream part of why we slave off ourselves so much will never be true as well.

I don't think that we're heading into a zombie apocalypse level destruction. Highly skilled people will always have one of the best lives. But it gets harder for everybody, and no matter how much we complain there isn't anybody who can give us a better life at the moment. Everybody is losing something.

Re: The Dark Side of Doctoring

#162

Post by Kluny »

stickfigure wrote: post #157
nathancahill wrote: post #115

Earlier quoted context omitted.

More book recommendations on HN should be a link to a good review like this, instead of just an Amazon link.

Sure - convince Scott Alexander to review more books? The problem is the supply of good reviews like this.

Sivers.org has got reviews and cliff notes for quite a lot of HN's favorite books, if you're interested. They're actually such good summaries of the books that a lot of the time I just read his synopsis and skip the book.

Re: The Dark Side of Doctoring

#163

Post by robk »

pixelmonkey wrote: post #18

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…

Leverage is the exact point. The problem is that due to their compassion and altruism they have no leverage. Design a system where doctors have to choose between destroying themselves and saving patients and they ethically are forced to destroy themselves. It's tragic and just as bad under socialised medicine if not worse.

Re: The Dark Side of Doctoring

#164

Post by timwaagh »

a surgeon is considered replacable? they just might be the least replacable professionals out there. i don't know what he is thinking. doctors are the elite. at least where i live a surgeon can out-earn even government ministers and CEO's.

indispensible. irreplacable. the rest of the industry should therefore be focussed on getting as much value out of these doctors. which means they should be focussing on taking any paperwork out of docs hands.

Re: The Dark Side of Doctoring

#165

Post by robk »

slackingoff2017 wrote: post #108
pixelmonkey wrote: post #18

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…

It's well known within the medical field that being a doctor is really really tough. It takes a lot of smarts and grueling years in residency before you officially become a doctor. However it also pays incredibly well. Even moreso for specialities and surgeons, who can make over 200k a year even in low cost of living areas. Despite the difficulties of being a doctor it's harder to get into medical school than ever. T…

Definitely does not pay well in UK

Re: The Dark Side of Doctoring

#166

Post by m_fayer »

hammerzeit wrote: post #32
pixelmonkey wrote: post #18

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…

My spouse is a doctor as well, and I've also observed the issues the author discusses. I don't think your read of the causes here is correct. It's worth reading more about the history of medicine to truly understand what's going on here -- the culture of abusive overwork in American medicine goes at the very least back to Osler and the invention of the modern residency program, and has as much to do with cocaine than…

Yes I think this is an important point, medical culture plays a big role in this. The only place I've seen a similar culture is in the army.

If you're exhausted or in physical pain or have a cold, you not only power through it but you suck it up and refrain from complaining, even if you're assisting a surgery. You may be officially encouraged to know and respect your limits, but if you actually do this you quickly go from being a "brother in arms" to weak and unsuited for the profession.

Re: The Dark Side of Doctoring

#167

Post by saiya-jin »

slackingoff2017 wrote: post #108
pixelmonkey wrote: post #18

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…

It's well known within the medical field that being a doctor is really really tough. It takes a lot of smarts and grueling years in residency before you officially become a doctor. However it also pays incredibly well. Even moreso for specialities and surgeons, who can make over 200k a year even in low cost of living areas. Despite the difficulties of being a doctor it's harder to get into medical school than ever. T…

Doctors are generally paid OK, but - most of them are idealists who want to help people DESPITE all the grueling work required. Maybe in US it's more ridiculous, but here in Europe (Switzerland), when I compare myself (software dev in bank) and my fiancee (internal doctor) -

(1) I get paid more for doing office work;

(2) I work much less, practically no weekends, no overtime, 8 hours day (she has 10-15, weekends, overtime not paid, night shifts that properly mess you up);

(3) I make mistake, even in production, no big deal - worst possible scenario bank would lose tiny bit of money, I could be theoretically fired. If she makes any mistake in her 40 years career, she can easily kill a person, go to jail, end up having massive debt (there is possible costly insurance for that) and having doctor license permanently revoked. Life ruined.

This is Switzerland - one of biggest hospitals in the country, and she is nowhere those numbers you mention, and unless she opens some private practice with tons of clients she never will. Surgeons are better-off, but they have literally 0 life, it's work -> sleep -> work -> sleep pattern, rushing to hospital at 3 am to do 10 hour surgery.

So quit your whining and pretty apparent envy, it's pathetic. Those people are among the most useful humans mankind currently has, definitely more useful than me, and I can bet quite a fortune same goes for internet nobody like you.

Re: The Dark Side of Doctoring

#168

Post by Lordarminius »

seanp2k2 wrote: post #130
slackingoff2017 wrote: post #108

Earlier quoted context omitted.

It's well known within the medical field that being a doctor is really really tough. It takes a lot of smarts and grueling years in residency before you officially become a doctor. However it also pays incredibly well. Even moreso for specialities and surgeons, who can make over 200k a year even in low cost of living areas. Despite the difficulties of being a doctor it's harder to get into medical school than ever. T…

200k is also on the low end. A friend of mine just finished her residency and is making almost twice that now. I did some on-site PC service for a few doctors in a job about a decade ago. They literally all had 911s and mansions. Anecdotal sure, but from what I've seen, doctors here are loaded. Anesthesiologist always seemed like the best gig....you work a few days a week, set up your schedule months ahead of time, b…

You possess an uninformed opinion of what it takes to practice medicine at an acceptable level.

Re: The Dark Side of Doctoring

#169

Post by m_fayer »

slackingoff2017 wrote: post #108
pixelmonkey wrote: post #18

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…

It's well known within the medical field that being a doctor is really really tough. It takes a lot of smarts and grueling years in residency before you officially become a doctor. However it also pays incredibly well. Even moreso for specialities and surgeons, who can make over 200k a year even in low cost of living areas. Despite the difficulties of being a doctor it's harder to get into medical school than ever. T…

I'd like to see you maintain your "cry me a river" perspective when the doctor tasked with saving your kids life is burnt out and going through a divorce because of his chosen career.

And even if I were to agree with your premises, do we really want a system that selects for the kind of doctors who are willing to put themselves and their loved ones through years of hell in exchange for an eventual high and stable paycheck? What kind of people are these? Are they the kind of people you'll trust to treat your scared child gently and empathetically?

Re: The Dark Side of Doctoring

#170

Post by dahauns »

kem wrote: post #66
pixelmonkey wrote: post #18

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…

There's one big difference between software engineers and healthcare: regulation. A software engineer is hired for their skills (at least ostensibly). No one is required by law to hire someone with a specific degree and specific post-degree training and specific exams. Contrast this with healthcare. To do certain sorts of procedures, you have to hire a physician. Not because it's demonstrably necessary to have someon…

Great story. And now do the comparison with airlines, for example. Or is "safety" as an argument fine there?
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