Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

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

niskanencenter.org

Post reply on HN
Print view View original

111–120 of 377 posts

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

#111

Post by was_a_dev »

pcrh wrote: post #70

A similar phenomenon occurred in the UK, where under fears of "medical unemployment", the British Medical Association argued against increasing medical school places [0]. The attitude persists even today, where the BMA advocates that medical school entries should be limited to the number of specialty training places that follow basic training, so as to avoid the risk of doctors becoming unemployed or under-employed.…

While this is a problem. The single largest issue that isn't properly being disscussed (especially during the strikes) is retention.

The NHS is a leaking bucket of highly skilled doctors and nurses.

Anecdotally, my wife is a doctor at a large tertiary hospital. Asking all the completing Foundation junior doctors what their career plans are, 80% of them have obtained either an Australian or New Zealand Visa and were securing jobs abroad.

No one skilled and smart enough wants to stay in the UK.

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

#112

Post by [deleted] »

xvedejas wrote: post #72
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…

The biggest complaint I always hear from people in the medical field is the long hours. It sure sounds to me like that (and thus any knock-on problems) could be solved by more practitioners, spreading the work around. I can't speak for you, but personally, a proper work-life balance in comparison to these horror stories is surely worth a possible salary cut?

[deleted]

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

#113

Post by Dalewyn »

wrp wrote: post #110

What is a nutshell explanation of how healthcare got to the overall shortage state? (For the USA, but curious about other countries.) In the past 20 years, costs have shot up, doctors are seeing many more patients, and quality of care seems to have generally declined. Where have the resources gone? In the 1990s my GP had time to shoot the breeze for 20 minutes or more. Now I get a 5-minute diagnosis on the run, after…

Grossly insufficient pay for the work concerned. This applies to everywhere, US and otherwise.

Unless you are a saint given existence upon this mortal plane instead of the high heavens, there are simply no objectively good reasons for ordinary men to pursue a career in medical.

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

#114

Post by lotsofpulp »

wrp wrote: post #110

What is a nutshell explanation of how healthcare got to the overall shortage state? (For the USA, but curious about other countries.) In the past 20 years, costs have shot up, doctors are seeing many more patients, and quality of care seems to have generally declined. Where have the resources gone? In the 1990s my GP had time to shoot the breeze for 20 minutes or more. Now I get a 5-minute diagnosis on the run, after…

>Where have the resources gone? In the 1990s my GP had time to shoot the breeze for 20 minutes or more. Now I get a 5-minute diagnosis on the run, after scheduling months in advance.

See the population pyramid getting older and the general decline of healthiness / increase in proportion of people with health problems.

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

#115

Post by [deleted] »

wrp wrote: post #110

What is a nutshell explanation of how healthcare got to the overall shortage state? (For the USA, but curious about other countries.) In the past 20 years, costs have shot up, doctors are seeing many more patients, and quality of care seems to have generally declined. Where have the resources gone? In the 1990s my GP had time to shoot the breeze for 20 minutes or more. Now I get a 5-minute diagnosis on the run, after…

[deleted]

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

#116

Post by 2b3a51 »

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.

UK: there was a proposal to introduce weekend surgery to make better use of operating theatres. The problem is staffing the facilities. Lead times on training people are long. And in UK the training process is not cheap and has significant up-front costs for the people being trained. Nurses as well as surgeons.

We used to have bursaries to cover the cost of training for nurses, but, austerity and all.

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

#118

Post by badpun »

whitemary wrote: post #14
bruce511 wrote: post #6

Planning and predicting highly variable systems is hard. Long-range interventions are especially risky given the possibilities for unexpected consequences and also the long lead times in fixing the problems. Central planning on resources has been especially rife with failed examples (the USSR being the all-in poster child.) As the article points out, the concept of central planning is orthogonal to who is providing t…

"Communist" Cuba has 64 physicians per 10K population, which is 2nd in the entire world for physicians per capita. https://en.m.wikipedia.org/wiki/List_of_countries_and_depend... During the pandemic, they were sending droves of doctors to Europe. They offered to assist in NYC but Trump turned them away as our population dwindled. Famously, when a British cruise ship with ill passengers aboard was denied by ports in F…

Some of those physicians (mostly young and female) take second jobs as prostitutes, because their baseline pay makes it hard to survive.

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

#119

Post by Traubenfuchs »

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…

Your income is relatively insane (multiple 100k), you have ultimate job security even in old age, opening a private practice makes your income essentially open ended depending on how much hard work you put in, you can help your loved ones and yourself to better navigate health care, will always receive priority treatment and probably have the job with the highest social standing that exists.

I don‘t know what it is with doctors world wide having zero awareness of their maximum privilege and zero perspective on how their average and median fellow citizens do.

Yes it‘s hard, but so are many, many other jobs you don‘t hear much about.

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

#120

Post by jimmydddd »

weatherlite wrote: post #105
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…

> There's just no reason to do the job when you can get the same compensation working remotely in tech. Looking through the "Who's Hiring" thread is soul-crushing. Physician salaries are the only ones that do not grow relative to inflation and have decreased year-on-year relative to inflation for decades. What ? Most U.S physicians make 300K + after residency with job security set for life. The real bright ones, the…

The job security issue is huge. Many of my tech and finance friends in their early 50's are getting pushed out of their jobs, while my physician friends in their 60's can keep their career as long as they want. A family member recently visited a dr. in his late 70's.
Post reply on HN