The planning of U.S. physician shortages (2020) • Hacker News Board

Re: The planning of U.S. physician shortages (2020)

#81

Post by bruce511 » Sat, Jun 03, 2023, 6:24 AM UTC

chaostheory wrote: post #61

DSingularity wrote: post #15

Earlier quoted context omitted.

I feel like we are going too far. Central planning in presence of hostile adversaries unrestricted by any ethical systems failed. And by what measures has “free market” has proven itself as successful? You can come up with your measures of success and others will propose measures of shortcoming. Others will even dispute the claim the American-led west is anything different from a centrally planned set of cooperating…

> Central planning in presence of hostile adversaries unrestricted by any ethical systems failed. This is what happens in any system that leans too much on central planning. What we’re witnessing is just entropy ie late stage capitalist society in decline due to too much power being centralized. It’s not exclusive to capitalist economies. Historically, it’s even worse in primarily socialist economies because there ar…

I don't know for sure, but I feel like you're possibly conflating socialism with communism? They are really quite different political models, although I'll grant you that both have a spectrum of examples.

Equally capitalism, socialism and communism are all (somewhat) tangential to government organisation (single party, two party, multiparty, monarchy, dictator etc.)

And I understand here that I'm painting with a very broad brush here - grouping some very dissimilar things together under the same terms while disregarding a lot of nuance)

Re: The planning of U.S. physician shortages (2020)

#82

Post by mv » Sat, Jun 03, 2023, 6:26 AM UTC

MauroIksem wrote: post #58

lotsofpulp wrote: post #26

Earlier quoted context omitted.

There already has been. The solution was to pump out physician assistants (PAs) and nurse practitioners (NPs) that require a fraction of the training of a doctor to get licensed, and then have them practice medicine under the “supervision” of a doctor. Some states even went as far as giving people with no medical training the right to prescribe, such as naturopaths, whatever that means. So it is up to each person now…

You're being disingenuous. PAs are required to have 2000 hours of clinical experience before they can sit for their licensing exam. NPs however only require 500 hours. MDs require 4000 hours.

Where are you getting this 4000 hrs number from?

I’m a MD and this isn’t even remotely correct and the number seems to be pulled out of thin air. Comparing a 2 year PA program with a 4 year MD program plus mandatory 2-7 year additional training is extremely disingenuous.

Re: The planning of U.S. physician shortages (2020)

#83

Post by lostlogin » Sat, Jun 03, 2023, 6:28 AM UTC

whimsicalism wrote: post #80

lostlogin wrote: post #77

Earlier quoted context omitted.

> It sure sounds to me like that (and thus any knock-on problems) could be solved by more practitioners, spreading the work around. Sort of. The equipment is so expensive that the actual solution is usually to work the rooms and equipment harder. Night shifts, early starts and evening work are actually shit.

That makes no sense, if the capital is expensive then you should hire more labor.

That is literally what I'm saying. Staff are worked harder as shifts are introduced. It is not a nice way to work. Sure, it helps reduce the number of patients, but it destroys work/life balance and that is what the OP was raising as an issue.

It is also hard to get patients to agree to having tests done at 5am or 9pm, so it's a case of diminishing returns. The staff penal rates go up too, so the squeeze comes from all sorts of directions.

Re: The planning of U.S. physician shortages (2020)

#84

Post by ch4s3 » Sat, Jun 03, 2023, 6:29 AM UTC

toast0 wrote: post #79

ch4s3 wrote: post #52

Earlier quoted context omitted.

I'm not sure how they could have assisted with anything, they basically have no medical supplies[1][2][3][4]. And before you bring it up, no medical supplies aren't covered by the embargo, they get a special exemption since the 90s. [1] https://havanatimes.org/cuba/medicine-shortages-a-challenge-... [2] https://www.reuters.com/world/americas/cuban-diaspora-sends-... [3] https://www.sabcnews.com/sabcnews/south-african…

There was a time where supplies was the issue, and I doubt Cuba could help there. But there was also a time when medical labor was the issue, and Cuban doctors could have helped with that.

Probably not. They definitely wouldn’t have had training with modern medical equipment, which isn’t available in Cuba. Also we take a dim view here on slave labor which is the most accurate way to describe the Cuban medical mission.

Re: The planning of U.S. physician shortages (2020)

#85

Post by shadowofneptune » Sat, Jun 03, 2023, 6:34 AM UTC

whimsicalism wrote: post #80

lostlogin wrote: post #77

Earlier quoted context omitted.

> It sure sounds to me like that (and thus any knock-on problems) could be solved by more practitioners, spreading the work around. Sort of. The equipment is so expensive that the actual solution is usually to work the rooms and equipment harder. Night shifts, early starts and evening work are actually shit.

That makes no sense, if the capital is expensive then you should hire more labor.

The question is what you are angling for. If your goal is, sincerely, to provide better service, then you won't get it. Keep in mind that with so many patients nowadays being eligible for Medicare, the money will come in anyway. Nursing homes got the brunt of the attention for their quality of care, but with hospitals facing the same population the same management techniques come too.

I work as a nurse on nights and everything said above has been quite accurate. A textbook understanding of... well anything really, does not serve someone well now.

EDIT: Also these companies now often run pharmacies, investment systems, healthcare programs... patient care is by no means the biggest earner.

Re: The planning of U.S. physician shortages (2020)

#86

Post by merek » Sat, Jun 03, 2023, 6:39 AM UTC

the_d3f4ult wrote: post #62

Being a physician is a horrible career move right now. As a former Math/CS major turned eye surgeon, I can't help but think about how much easier my life would be had I stuck with tech. It's hard to understand exactly how hard the job is until you've lived it. I saw 40 patient's in clinic today in 8 hours without lunch or any kind of downtime and then spent 2 hours at the hospital because a patient needed an emergent…

Thanks for sharing. A couple of questions if I may:

For a typical surgeon in the US, how common are lawsuits from patients?

Do you have plans to run your own clinic (if not already doing so)? If so, would this address some of your current issues (work hours, compensation) at the risk of having to operate your own business?

Re: The planning of U.S. physician shortages (2020)

#87

Post by supahfly_remix » Sat, Jun 03, 2023, 6:40 AM UTC

> Physician salaries are the only ones that do not grow relative to inflation and have decreased year-on-year relative to inflation for decades.

Medical insurance has been increasing faster than inflation for a while now. Are only insurance companies getting this extra money? Are at least some medical professionals getting a cut?

Re: The planning of U.S. physician shortages (2020)

#88

Post by s1artibartfast » Sat, Jun 03, 2023, 6:42 AM UTC

the_d3f4ult wrote: post #62

Being a physician is a horrible career move right now. As a former Math/CS major turned eye surgeon, I can't help but think about how much easier my life would be had I stuck with tech. It's hard to understand exactly how hard the job is until you've lived it. I saw 40 patient's in clinic today in 8 hours without lunch or any kind of downtime and then spent 2 hours at the hospital because a patient needed an emergent…

Look at medical device and pharma companies with a strong optha pipeline.

I work with maybe 2 dozen retinal surgeons, and it seems like a pretty cushy gig. High 6 figure salary, mostly working from home, providing input for clinical trials and product development. Some do it part time and still maintain private practices.

Re: The planning of U.S. physician shortages (2020)

#89

Post by fragmede » Sat, Jun 03, 2023, 6:44 AM UTC

the_d3f4ult wrote: post #62

Being a physician is a horrible career move right now. As a former Math/CS major turned eye surgeon, I can't help but think about how much easier my life would be had I stuck with tech. It's hard to understand exactly how hard the job is until you've lived it. I saw 40 patient's in clinic today in 8 hours without lunch or any kind of downtime and then spent 2 hours at the hospital because a patient needed an emergent…

https://www.gene.com/scientists/ophthalmology

Re: The planning of U.S. physician shortages (2020)

#90

Post by matheusmoreira » Sat, Jun 03, 2023, 6:47 AM UTC

the_d3f4ult wrote: post #62

Being a physician is a horrible career move right now. As a former Math/CS major turned eye surgeon, I can't help but think about how much easier my life would be had I stuck with tech. It's hard to understand exactly how hard the job is until you've lived it. I saw 40 patient's in clinic today in 8 hours without lunch or any kind of downtime and then spent 2 hours at the hospital because a patient needed an emergent…

> Looking through the "Who's Hiring" thread is soul-crushing.

I know how you feel. I gave up on tech as a teenager and I still wonder what would've happened if I had stuck with it. Feels like it's impossible to switch careers now.

Where I live practicing medicine used to be a respectable profession but that's completely changed for the worse in the last 20 years. The communists currently running my country are literally quoted saying "we must create a new generation of leftist doctors who accept working for less". They flooded the job market with doctors.