Why you should not go to medical school • Hacker News Board

Re: Why you should not go to medical school

#101

Post by msellout » Sat, Sep 24, 2011, 5:16 PM UTC

roentgen wrote: post #88

Bloodwine wrote: post #86

Earlier quoted context omitted.

What protects you from outsourcing the reading of scans to foreign countries, such as India? Obviously some medical institutions will want to keep it all local, but won't this open up a market for cheaper, foreign competition resulting in a downward pressure on compensation?

See my other answers. "Final reads" must be performed my a physician who did a radiology residency in the USA, and credentialed in the USA. Note, you don't need to be located in the USA, but it doesn't matter, there is no competing on price. See my other answers. For each scan or xray performed, two fees are billed. The reimbursements are generally set in stone, and non-negotiable. Additionally, "fee-splitting" is Me…

Do you think this Medicare law is useful for protecting consumers?

Re: Why you should not go to medical school

#102

Post by gonehome » Sat, Sep 24, 2011, 5:17 PM UTC

mahyarm wrote: post #21

logjam wrote: post #19

I practice, but most of this article rings true for me as well, and I think most of my colleagues would consider me pretty idealistic. Residency training is mostly cheap labor for hospitals. Working 36 hours straight every third or fourth night (common when I was a resident) saves teaching hospitals from hiring night floats or other coverage. Trying to make any kind of important decision for another human's medical c…

It's ironic that it doesn't have to be this way at all. It's counter productive other than it makes someone richer. Doctors want to keep their high prices with artificial barriers such as these and the glamor keeps the supply relatively high.

The long hours and over working is more a factor of a hospital trying to save money than having anything to do with supposed 'price controls' being purposefully set up by doctors. The price comes mostly as a factor of the extremely expensive education (both in cost and time) that is necessary. If you want talented people in any field, especially one with such a laboring path of entry, you have to pay them well.

Re: Why you should not go to medical school

#103

Post by nandemo » Sat, Sep 24, 2011, 5:21 PM UTC

roentgen wrote: post #99

ender7 wrote: post #96

Earlier quoted context omitted.

If you are still in radiology, I'm not surprised by this. Radiology is one of the few times that you can be a doctor and expect to work something like a 9-5 day. There are other ways to have a decently normal life as a doctor, but on average it's a pretty hard life.

True, but I knew about the lifestyle when I picked radiology, and it is a very hard residency to get. There are others with a similar lifestyle, like Dermatology, Ophthalmology, and Radiation Oncology. Guess what? They are the hardest residencies to get into when you finish medical school. I should make clear why I'm replying in this thread. The world needs good doctors, and I want bright and ambitious readers of thi…

Meta-comment: how is it possible that 2 reasonable, informative comments from roentgen are being downvoted?

Re: Why you should not go to medical school

#104

Post by [deleted] » Sat, Sep 24, 2011, 5:35 PM UTC

nandemo wrote: post #103

roentgen wrote: post #99

Earlier quoted context omitted.

True, but I knew about the lifestyle when I picked radiology, and it is a very hard residency to get. There are others with a similar lifestyle, like Dermatology, Ophthalmology, and Radiation Oncology. Guess what? They are the hardest residencies to get into when you finish medical school. I should make clear why I'm replying in this thread. The world needs good doctors, and I want bright and ambitious readers of thi…

Meta-comment: how is it possible that 2 reasonable, informative comments from roentgen are being downvoted?

[deleted]

Re: Why you should not go to medical school

#105

Post by michaelochurch » Sat, Sep 24, 2011, 5:40 PM UTC

pavel_lishin wrote: post #94

michaelochurch wrote: post #64

Earlier quoted context omitted.

That post should go straight to the top. This is also why residents have to suffer ridiculous hours. With the severe limitations on the number of people who can become doctors, the profession is characterized by an extreme workload. It's seriously wrong. I, for one, would not want to be operated on by a surgeon who'd been working for 21 hours straight. Commercial pilots are limited to 40 flight hours per month, and w…

So, effectively pilots are only working 1/4th of the time that I work? Or is there non-flight-time work that eats up 120 more hours a month?

There's a fair amount of non-flight work. It'd say that it averages 120 hours of work time total per month. Less than we work, but with worse hours.

If you fly international with the majors, you're in good shape. Those guys make $200k easily, but those jobs are essentially inaccessible because the people who get them never retire. The rest make very little, and work a lot harder.

Re: Why you should not go to medical school

#106

Post by kenjackson » Sat, Sep 24, 2011, 5:40 PM UTC

roentgen wrote: post #98

kenjackson wrote: post #95

Earlier quoted context omitted.

This may be possible in some medical fields (I doubt it), but not radiology. There is simply too much to learn. I completed 4 years of medical school followed by a 5 year residency. Some radiologists go through additional sub-specialty training. I've been practicing for 5+ years, and I'm still learning everyday. But what can you say that about? I did 4 years undergrad in CS, followed by 5 years for a PhD. Followed by…

We see things differently. Radiology is a very difficult field to get into after medical school, something like 2/3 of American grads who apply get turned away. Additionally, for those who get in, up to 1/3 never pass all the board exams. It almost seems like you want to lower the bar, and I'm telling you it needs to be raised. My guess is that if your system was developed and worked, the intelligence and drive requi…

Radiology is a very difficult field to get into after medical school, something like 2/3 of American grads who apply get turned away. Additionally, for those who get in, up to 1/3 never pass all the board exams. It almost seems like you want to lower the bar, and I'm telling you it needs to be raised.

All you've said is that some tests aren't being passed. Can you correlate them with improved medical care? Again, in my alternate world, I can construct a CS test that 90% of those w/ undergrad CS degrees would fail. That's not hard to do. The question is "does my ability to pass such a test correlate with my ability to do a website?"

You're pointing to scarcity and arguing that this is proof that we require scarcity. I'm saying that if you dropped the bar on these tests, but increased other policing practices that yielded a net increase in the number of doctors, I think you'd see an increase in medical care. My thesis is purely speculative, I grant you that.

I suspect we're likely to find out if this does work out in non-US countries once as medical information and training becomes more prevalent on the web.

Re: Why you should not go to medical school

#107

Post by giardini » Sat, Sep 24, 2011, 5:45 PM UTC

pradocchia wrote: post #82

roentgen wrote: post #48

Earlier quoted context omitted.

I had a different experience. Medical school was easy, I was single and went out drinking / partying two or three nights a week. Not to be crass, but I did well with the ladies. Luckily I can get by on four hours of sleep or less. So, I don't feel like I missed out on much of the early twenties experience. Most of my non-medical friends had jobs and I didn't, but that was the only real difference. Things got a little…

> I make over 800k a year, and take 14 weeks of vacation. I, for one, am disheartened by this gross misallocation of resources, but good work on the vacation time.

The median salary for experienced radiologists is $300k-400k. And increasingly radiology has been outsourced overseas with mostly technicians required stateside (scan during the day, radiologist in India examines at night, results available the next morning).

But roentgen claims to be a businessman as well as a radiologist. If so, most of his income would be from several radiology businesses. In that case the 800k/year number would not be surprising.

Always remember

- "On the Internet no one knows you're a dog." and

- "Don't believe everything you read."

Re: Why you should not go to medical school

#108

Post by yason » Sat, Sep 24, 2011, 5:48 PM UTC

michaelochurch wrote: post #64

codexon wrote: post #26

The reason why it is so hard to become a doctor is because the AMA restricts the number of applicants and schools that can create doctors so wages can remain artificially high. http://www.forbes.com/2009/08/25/american-medical-associatio... http://gregmankiw.blogspot.com/2009/06/physicians-incomes-an...

That post should go straight to the top. This is also why residents have to suffer ridiculous hours. With the severe limitations on the number of people who can become doctors, the profession is characterized by an extreme workload. It's seriously wrong. I, for one, would not want to be operated on by a surgeon who'd been working for 21 hours straight. Commercial pilots are limited to 40 flight hours per month, and w…

There are commercial pilots and there are commercial pilots.

The senior staff can pretty freely pick the longest and easiest flights with the most turnover time, and thus they can enjoy eating and sleeping, and probably some shopping or exercising as well. On the other hand, if you're a young co-pilot you are likely to get the shittiest flights and the worst possible schedule, and you will probably find yourself in situations where you've flown more than your fair share of hours straight and you still have to haul one last plane home. And wake up next morning at 6am to begin a new shift.

I must say that planes have autopilot but operations don't. That might not be of much consolence, however.

Re: Why you should not go to medical school

#109

Post by true_religion » Sat, Sep 24, 2011, 5:55 PM UTC

roentgen wrote: post #97

kenjackson wrote: post #91

Earlier quoted context omitted.

Most people are not able to do this, and most of those few who could don't want to put themselves through it. Most people don't have to be able to do it, just more than are allowed to do it now, but a factor of say 10. Furthermore, I don't think people would necessarily need to go through med school and residency. It's like building a website. There's probably some parallel universe where programming requires certifi…

> I could imagine Khan Academy for Radiology taught by JHU and Harvard professors to be quite good. You have got to be kidding me. How would this work for surgery? There are no short cuts to medical competency. Sure, some of what I do is self-taught, I read books and articles, attend conferences, and complete Continuing Medical Education requirements. But I am able to do this because I attended medical school, then s…

Characterizing it as a "short cut" is disingenuous.

The argument here is that medical boards are too rigorous, and test things that do not matter practically.

To give a ridiculous example, if a medical school required you to climb Mount Everest before becoming a doctor that might result in only 1 person becoming a doctor per year. However that scarcity isn't proof that climbing Mount Everest is needed to become a doctor. Nor is it proof that cutting out that requirement will provide significantly worse doctors than previous.

Additionally, in many things we need quantity more than we need extreme compentancy. For example when cut, its better to have some kind of treatment (e.g. first aid, stitching) rather than waiting for a surgical specialist.

Re: Why you should not go to medical school

#110

Post by MrVitaliy » Sat, Sep 24, 2011, 5:56 PM UTC

What would be the picture of perfect 22-29 span? Being born with a silver spoon in a mouth? Partying every day?

I'm a CS grad student, married to med student. While our schedules are different, there isn't much difference in time. I'm mostly occupied with reading papers, grading papers, doing homework, grading homework and generally providing very cheap labor in a form of research assistantship and teaching assistantship to university.

To me, the experience of every point the author mentions is the sole reason for existence between 20-30 years of age.