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ERs are hiring fewer doctors to save money

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Re: ERs are hiring fewer doctors to save money

#21

Post by tyoma »

ganlaw wrote: post #7

Hospitals shouldn't be a profitable business. The primary goal of a hospital should be serving patients sickness. (Easier said than done) My partner is a physician at a hospital in NYC, and something that they are struggling with now is lack of social services for patients to get them out of hospital beds and into homes/rehabs. As a immigrant in this country, I am constantly flabbergasted by the state of healthcare h…

Almost every hospital organization is actually a non-profit.

However non-profit does not mean non-revenue.

Hospitals have real costs, and it is entirely possible the emergency department was a money sink. No one can be turned away, so it is used as the healthcare of last resort for those without other access, who, almost by definition, cannot pay.

Re: ERs are hiring fewer doctors to save money

#22

Post by oaktrout »

themitigating wrote: post #9
shiftpgdn wrote: post #5

Earlier quoted context omitted.

Counterpoint: You can go read the “Noctor” subreddit or ask any practicing physician why it’s bad for patient outcome. Ultimately we need more doctors and less hospital administrators.

Doctors say we need more of them and their high pay?

I'm sure the high paid software engineers at boeing said something similar when jobs were being outsourced "we need more US engineers". Look at the software problems they had and tell me they were wrong.

Just like software engineers are best qualified to evaluate software quality, doctors know medicine better than anyone else. Just because they are incentivized to protect their job doesn't mean they are wrong.

Re: ERs are hiring fewer doctors to save money

#23

Post by azinman2 »

klyrs wrote: post #17

> Private equity companies pool money from wealthy investors to buy their way into various industries, often slashing spending and seeking to flip businesses in three to seven years. The focus of the article is on physicians vs. NPs and PAs, but the real driver of the enshittification is, yet again, private equity firms extracting short-term profits, to hell with long-term outcomes.

We need to outlaw for profit anything with healthcare. The incentives are misaligned with society’s needs.

Re: ERs are hiring fewer doctors to save money

#24

Post by themitigating »

oaktrout wrote: post #22
themitigating wrote: post #9

Earlier quoted context omitted.

Doctors say we need more of them and their high pay?

I'm sure the high paid software engineers at boeing said something similar when jobs were being outsourced "we need more US engineers". Look at the software problems they had and tell me they were wrong. Just like software engineers are best qualified to evaluate software quality, doctors know medicine better than anyone else. Just because they are incentivized to protect their job doesn't mean they are wrong.

That's correct but I believe their bias makes them a untrustworthy worthy source

Re: ERs are hiring fewer doctors to save money

#25

Post by wahnfrieden »

azinman2 wrote: post #23
klyrs wrote: post #17

> Private equity companies pool money from wealthy investors to buy their way into various industries, often slashing spending and seeking to flip businesses in three to seven years. The focus of the article is on physicians vs. NPs and PAs, but the real driver of the enshittification is, yet again, private equity firms extracting short-term profits, to hell with long-term outcomes.

We need to outlaw for profit anything with healthcare. The incentives are misaligned with society’s needs.

Why only healthcare specifically?

Re: ERs are hiring fewer doctors to save money

#26

Post by azinman2 »

ourmandave wrote: post #14

My last ER visit I was seen by a PA, which is fine. They're more than competent. The part I didn't like was how they made me get out a credit card while they we're treating me. Which, according to a story by the NY Times, is a common thing. Send a nurse around with a swipeable tablet to ask how you'd like to pay. https://www.nytimes.com/2023/01/25/podcasts/the-daily/nonpro...

Same thing happened to me in Canada.

Re: ERs are hiring fewer doctors to save money

#27

Post by MisterBastahrd »

shiftpgdn wrote: post #5
wyldfire wrote: post #3

> While diagnosing and treating patients was once doctors' domain, they are increasingly being replaced by nurse practitioners and physician assistants, collectively known as "midlevel practitioners," who can perform many of the same duties and generate much of the same revenue for less than half the pay. IMO, PAs and NPs are a good idea for medicine overall. Especially since lots of folks who would consider a career…

Counterpoint: You can go read the “Noctor” subreddit or ask any practicing physician why it’s bad for patient outcome. Ultimately we need more doctors and less hospital administrators.

If we need more doctors then it's time for doctors to rectify that themselves. Doctors and dentists both gatekeep their professions because of money, not because of talent.

Re: ERs are hiring fewer doctors to save money

#28

Post by conscion »

abfan1127 wrote: post #13
ganlaw wrote: post #7

Hospitals shouldn't be a profitable business. The primary goal of a hospital should be serving patients sickness. (Easier said than done) My partner is a physician at a hospital in NYC, and something that they are struggling with now is lack of social services for patients to get them out of hospital beds and into homes/rehabs. As a immigrant in this country, I am constantly flabbergasted by the state of healthcare h…

Profit is a strong incentive to optimize. non-profit organizations are under different incentives. They both have pitfalls, they both have advantages.

Profit is a strong incentive when there's active competition. When there's not competition, for-profit business turn to extracting rents on captive customers.

Health care larger is not a competitive market. Lots of customers only have limited options (i.e. rural hospitals) and the urgency of some purchases don't support competition (i.e. ER visits)

Re: ERs are hiring fewer doctors to save money

#29

Post by idopmstuff »

ganlaw wrote: post #7

Hospitals shouldn't be a profitable business. The primary goal of a hospital should be serving patients sickness. (Easier said than done) My partner is a physician at a hospital in NYC, and something that they are struggling with now is lack of social services for patients to get them out of hospital beds and into homes/rehabs. As a immigrant in this country, I am constantly flabbergasted by the state of healthcare h…

I think only allowing nonprofit hospitals would be worse than the current state of affairs. You'd still be asking private organizations to be responsible for ensuring we have adequate medical treatment available, but you'd very literally be relying on the charity of strangers to ensure that. For-profit medicine at least provides excellent incentives for corporations to spend the enormous sums of money needed to set up and run hospitals.

If you're against hospitals being for-profit businesses (which I think is a perfectly reasonable stance), it seems to me the real alternative would be government-run hospitals. Then you'd have a centralized, well-resourced organization that is generally incentivized to keep people healthy running things, rather than just hoping that enough non-profits get involved to serve the medical needs of the country.

Re: ERs are hiring fewer doctors to save money

#30

Post by rqtwteye »

adam_arthur wrote: post #16
ganlaw wrote: post #7

Hospitals shouldn't be a profitable business. The primary goal of a hospital should be serving patients sickness. (Easier said than done) My partner is a physician at a hospital in NYC, and something that they are struggling with now is lack of social services for patients to get them out of hospital beds and into homes/rehabs. As a immigrant in this country, I am constantly flabbergasted by the state of healthcare h…

Most hospitals are already losing money or close to losing money. Taking away profit motive from them e.g. by subsidizing operation would only increase cost of care, because the incentive to run lean/efficiently goes away. The insurance system and perverse incentives embedded in it is the primary reason healthcare is expensive here. Also many countries have price controls on drugs, and US does not (thus subsidizing R…

"Also many countries have price controls on drugs, and US does not (thus subsidizing RoW in regards to new drug research)"

I think this line is BS propaganda by the pharmaceutical industry. I am 100% sure the US would be way better off if they controlled prices and then subsidized research directly instead of paying outrageous prices.

As far as hospitals losing money, this doesn't mean that they are using their money efficiently. My ex used to do auditing of hospitals and a lot of them showed a circle of friends consisting of local construction company, architects, business consultants, doctors and others. They all lived well on charging a lot of money to the hospitals and the hospital execs didn't check because they were all buddies.

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