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The darker side of being a doctor (2017)

drericlevi1.substack.com

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Re: The darker side of being a doctor (2017)

#41

Post by OldGuyInTheClub »

gnarbarian wrote: post #24
metalcrow wrote: post #20

It seems to me the only way to fix this problem, aside from some sort of large regulatory changes by the government, is for doctors to start unionizing or striking to force better conditions. What would happen if doctors simply refused to do more then 60 hours a week? Is there really enough supply of new doctors coming in that the hospital can just fire them all and replace them with doctors willing to burn themselve…

they can always join or open their own practice.

The costs to start, staff, and sustain a practice large enough to deal with insurance is prohibitive. A few private practice doctors I know socially are getting out early because they can't deal with the b.s. anymore.

Re: The darker side of being a doctor (2017)

#42

Post by newzisforsukas »

whoomp12342 wrote: post #30
newzisforsukas wrote: post #10

Why do doctors have families on top of a demanding career then complain about it when they are over burdened? They put themselves in that situation. They can also leave that situation whenever they want. Then to go on sadfishing with this border-line masochism in a blog post...

you forget that doctors go way into debt for their education and training. so no, they might not be able to leave that situation quite so easily. why would you blame someone for wanting to have a family? do you hang out with the grinch?

> do you hang out with the grinch?

I don't presume anyone can have and do everything. There are constraints on life, and concessions need to be made for certain goals.

Re: The darker side of being a doctor (2017)

#43

Post by SlavikCA »

I saw quite a few of similar situations, when people are doing their best, because they're responsible, and if they will not take care of things - something bad will happen.

I always suggest the "principle of lost packets".

Let things fail early to inform about your limitations. If your internet connection speed is 30Mbps and you send 100Mbps upstream - some packets will be dropped. The earlier packets get dropped - the better for the connection, because feedback will be faster. Ideally at your router.

Practically speaking, for the case in the article: We have 6 doctors working at our hospital. One doctor quits. Look, we're doing ok with 5! Let see, can we do with 4? Sure. Ok, now we're with 3 doctors and things are failing... So, 4 is probably optimal. Well, that 4 doctors working on the edge. Would this doctor "fail the hospital" earlier, - hospital will receive that signal, and doctor's count will be higher.

Few years ago I was promoted to be QA Manager, and learned very quickly, that a lot of people will make sure that I know, that if our QA team will not sign off on that release - we'll lose that deal, or make that client unhappy... At the beginning I tried to accommodate. But that was totally unsustainable. So, I quickly learned to give people realistic expectations: - no, will not complete QA by Friday, tell the client whatever you want, or give me 2 more people (and the only people they can give me were Developers). - no, will not have that release ready by 12th, you should have consulted with me before making promise, not it's on you to figure out, not my headache.

Re: The darker side of being a doctor (2017)

#45

Post by [deleted] »

whoomp12342 wrote: post #28
hcarvalhoalves wrote: post #13

This isn’t a mental health issue of an individual. Medicine is severely understaffed and professionals are burned out, worldwide. Doctors should be as common as plumbers given the demand but often, I can’t get an appointment with a doctor within 30 days.

you realize that plumbing is currently one of the highest paid trades because of a shortage?

[deleted]

Re: The darker side of being a doctor (2017)

#46

Post by sandworm101 »

metalcrow wrote: post #20

It seems to me the only way to fix this problem, aside from some sort of large regulatory changes by the government, is for doctors to start unionizing or striking to force better conditions. What would happen if doctors simply refused to do more then 60 hours a week? Is there really enough supply of new doctors coming in that the hospital can just fire them all and replace them with doctors willing to burn themselve…

They are unionized already. They have independent state licensing boards staffed and operated by other Doctors. These organizations manage the profession and more or less set the standards to which doctors in the state are held.

Re: The darker side of being a doctor (2017)

#47

Post by ghnws »

kristjansson wrote: post #35

Sounds like many of the acute problems are microfrustraions created by poor software design and engineering. Slow login/relogin, unrealistic scheduling, illegibility of pre- and post-surgical tasks to the timekeeper, etc. We can't solve the structural problem, but better software could help create more humane working environment under the constraints. Of course, the real problem is running medicine like a business, b…

The article reads like all the little annoyances is what is wrong when the doc is expected to work almost 24/7 for days on end. No amount of software improvement will make any realistic improvements.

It's insane that a truck driver _must_ have 8 hours of sleep before work (they should, not arguing against it), but a surgeon can work with a couple of naps for days.

Re: The darker side of being a doctor (2017)

#48

Post by cortesoft »

schu wrote: post #18
strongpigeon wrote: post #3

Slightly off-topic: I know the Substack says 2024, but I remembered reading this very same post before. Turns out it's from 2017 [0]. [0] https://www.medicalrepublic.com.au/dark-side-doctoring/1063

Also, two months ago: https://news.ycombinator.com/item?id=40025261

And the link from that post is now broken... so the author took down the previous time they posted this to their substack, and then reposted it with today's date?

Re: The darker side of being a doctor (2017)

#49

Post by karmakurtisaani »

kristjansson wrote: post #35

Sounds like many of the acute problems are microfrustraions created by poor software design and engineering. Slow login/relogin, unrealistic scheduling, illegibility of pre- and post-surgical tasks to the timekeeper, etc. We can't solve the structural problem, but better software could help create more humane working environment under the constraints. Of course, the real problem is running medicine like a business, b…

I keep asking myself why they hire the worst developers to do time recording software. Ones who can't design an intuitive UI, can't make it help you automate recording, can't make it respond without 1-2 second delay every time.. Of course HR needs us to log in our hours in these systems, and then the managers tell us what hours to put where. It's absurd all the way.

Having been exposed to this only a little, I can imagine what kind of garbage the medical staff has to endure to make their reports and time keeping.

Re: The darker side of being a doctor (2017)

#50

Post by jimbokun »

kristjansson wrote: post #35

Sounds like many of the acute problems are microfrustraions created by poor software design and engineering. Slow login/relogin, unrealistic scheduling, illegibility of pre- and post-surgical tasks to the timekeeper, etc. We can't solve the structural problem, but better software could help create more humane working environment under the constraints. Of course, the real problem is running medicine like a business, b…

There is a strong argument to be made that paper charts were more efficient and provided better quality documentation with better user experience than modern EMR software systems.

Also, this is one place where AI can potentially provide both a more efficient system and greatly improve job satisfaction for physicians. Automatically generating and updating medical records based off ambient recordings of patient interactions fits right into LLMs wheelhouse.

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