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Stanford apologizes after vaccine allocation leaves out medical residents

npr.org

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Re: Stanford apologizes after vaccine allocation leaves out medical residents

#121

Post by epmaybe »

amb23 wrote: post #12

The labor of medical residents is something hospital systems exploit during normal times, but that exploitation has severely deepened during the pandemic. At the hospital my partner works at, respiratory therapists and nurses got a $10k bonus for working during COVID; the residents got nothing despite working insane hours in ICU, routinely working more than the legally mandated 90 hours per week. Just because doctors…

small quibble - the limit is supposed to be 80hrs/wk

I thought about a top level comment to link this, but we are naming and shaming programs that exploit residents during this time.

https://docs.google.com/spreadsheets/d/1ZgEKvTr1lvTLHsREeill...

Re: Stanford apologizes after vaccine allocation leaves out medical residents

#122

Post by edoceo »

leg100 wrote: post #110
edoceo wrote: post #45

Earlier quoted context omitted.

C-Suite and WFH admins - the low risk, safe group. The system forgot front-line infantry (again)

Source? The article irritatingly doesn't say.

SfGate and NYT articles mentioned execs and admins.

I can't find direct links on mobile

Re: Stanford apologizes after vaccine allocation leaves out medical residents

#123

Post by fragmede »

bosswipe wrote: post #118
smnrchrds wrote: post #53

Earlier quoted context omitted.

"Machine learning is like money laundering for bias" https://twitter.com/pinboard/status/744595961217835008

There's no way they used machine learning here. My guess it was some simple rules like older doctors go first. I wouldn't even call it an algorithm. I think algorithm is a weasly way for the administrator to make it sound more complicated then it was.

As computer scientists and adjacent, we have a whole taxonomy for algorithms. It should be noted that "sort by salary" is an algorithm.

Re: Stanford apologizes after vaccine allocation leaves out medical residents

#124

Post by [deleted] »

tmotwu wrote: post #9
mmastrac wrote: post #3

The great thing about an algorithm is that when it gives you results that benefit you, you can accept them and then pass the buck on to it when people get outraged: "According to an email sent by a chief resident to other residents, Stanford's leaders explained that an algorithm was used to assign its first allotment of the vaccine. The algorithm was said to have prioritized those health care workers at highest risk…

The whole mess has demonstrated why ethical AI research is important. It's so easy for people to disregard why and how biases exist in their systems when it doesn't affect them personally.

[deleted]

Re: Stanford apologizes after vaccine allocation leaves out medical residents

#125

Post by bosswipe »

fairity wrote: post #28
jrochkind1 wrote: post #15

> "[A]lgorithms are made by people and the results ... were reviewed multiple times by people," You got that right. The way they talk about "an algorithm did it" makes it seem as as if they think that somehow explains it, like there was only one algorithm possible handed down from god or something. We'll be seeing more and more of this of course. "We can't be blamed, it was an algorithm! We can't be blamed for trusti…

I think most people are misunderstanding the likely root cause. > An algorithm was used to assign its first allotment of the vaccine. The algorithm prioritized health care workers at highest risk for COVID infections, along with factors like age and the location or unit where they work in the hospital. Residents did not have an assigned location, and along with their typically young age, they were dropped low on the…

I don't like the use of the word algorithm there. I would call it rules or formulas. Algorithm makes it sound like something more complicated when it was probably just a SQL query.

Re: Stanford apologizes after vaccine allocation leaves out medical residents

#126

Post by renewiltord »

trianglem wrote: post #107
jrochkind1 wrote: post #15

> "[A]lgorithms are made by people and the results ... were reviewed multiple times by people," You got that right. The way they talk about "an algorithm did it" makes it seem as as if they think that somehow explains it, like there was only one algorithm possible handed down from god or something. We'll be seeing more and more of this of course. "We can't be blamed, it was an algorithm! We can't be blamed for trusti…

With you right until the end where formulas are made by people. In many NN setups, the “formula” is pretty much a self trained black box so in those cases people can only be blamed for the input data that went into training the system.

That's a bit like saying "I didn't burn the food. The stove burned the food. I just put the food on the stove".

Re: Stanford apologizes after vaccine allocation leaves out medical residents

#127

Post by doctoring »

throwaway9870 wrote: post #40

I can't really get upset until I understand who got it instead of the resident.

The residents who didn't get it: those working 80+ hrs/week in the emergency room, in the ICU, intubating patients, operating on patients, etc etc etc

Some people I know of who got it instead: Radiologists who primarily work from home. Administrative roles with relatively low (or no) patient interaction.

Not saying those people shouldn't get vaccinated -- just that if you were asked to come up with a priority list, it wouldn't be this.

Disclosure: am a physician at Stanford.

Re: Stanford apologizes after vaccine allocation leaves out medical residents

#128

Post by renewiltord »

neilv wrote: post #57
chromatin wrote: post #51

Evidence like this suggest that medical leadership for the most part care very little about house officers (residents), and that is pretty universal. Our institution built a new billion dollar hospital and did not include call rooms. Great job.

I found this opinion interesting: https://www.kevinmd.com/blog/2015/09/how-call-rooms-reflect-...

Short summary for people who don't want to read it: author says that call rooms were for functionality and that they believe that call room quality and medical learning quality are non-correlated. Author does not discuss absence of call rooms.

Only adding that summary because I assumed, given context of GP, that absence of call rooms would have been discussed. If you're like me, hope I've saved you the time.

Re: Stanford apologizes after vaccine allocation leaves out medical residents

#129

Post by courtf »

There is incredible pressure to give out vaccine to those with the tallest soapbox from which they can harass decision makers. And of course, said decision makers aren't exactly known for their backbone when handling conflict, so we get situations like this. Administrators often don't even know who in the hospitals spends the most time around sick patients. Entire front-line departments are forgotten, primarily because they don't have any political power or representation.

To see such a highly regarded institution fail this very simple test is another example of how the human creature needs more time to evolve. It's not just a mistake, this is a pattern playing out all over. Anyone who spends time in these environs would not be much surprised, but when the best hospitals still can't take care of their most vulnerable staff because of pernicious political maneuvering, the contrast between perception and reality is all the more stark.

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