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Why doctors are sick of their profession

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Re: Why doctors are sick of their profession

#41

Post by bps4484 »

wirrbel wrote: post #35
727374 wrote: post #11

I think it's funny that the first picture in the article is of a doctor taking a patient's blood pressure. It's a little ironic because I've never actually had a doctor take my blood pressure (in the US). I'm not even sure if I've had a nurse do it, but more likely a physician's assistant or phlebotomist. Just like other industries medicine has been turned into an assembly line where patients are herded through the s…

What has always confused me is that the perceived gap between doctors and nurses is so big. I have the impression that nurses could benefit a lot from better training and there could be a good case for positions somewhere between a nurse and a doctor. Considering the effect that _care_ (time with patient) has on patients the current model with a demi-god in white just does not scale. My optometrist (the guy selling g…

"positions somewhere between a nurse and a doctor"

I think this is what a physicians assistant and nurse practitioners are. At least that's my understanding. They don't have an MD but are able to do a number of diagnostics and can prescribe medicine.

Re: Why doctors are sick of their profession

#42

Post by javert »

toasted wrote: post #38

Non-US anaesthesiologist here. I love my job and relish going to work each morning. I spend almost no time on non-clinical paperwork. I work reasonable hours, have some busy on-call shifts but am generally well supported by my department. I earn good money in the state system - enough to raise a family comfortably and have a nice house, but not silly money. I pay no malpractice insurance, but pay $400 annually to a n…

The actual experience in the US has been that healthcare functioned best when it was closest to a free market, and the more we socialize it, the worse it gets. (We have been slowly socializing it for many decades through regulation.)

You can argue that we haven't been socializing it "properly," but the way we are doing it is just the way government works in the US, and that's not going to change.

In general, we don't have an efficient, honest, effective government, so it can't do anything right on a large scale. Though there are some exceptions, those are exceptions. Look at the Obamacare website scandal. That is the rule.

Re: Why doctors are sick of their profession

#43

Post by eli_gottlieb »

javert wrote: post #42
toasted wrote: post #38

Non-US anaesthesiologist here. I love my job and relish going to work each morning. I spend almost no time on non-clinical paperwork. I work reasonable hours, have some busy on-call shifts but am generally well supported by my department. I earn good money in the state system - enough to raise a family comfortably and have a nice house, but not silly money. I pay no malpractice insurance, but pay $400 annually to a n…

The actual experience in the US has been that healthcare functioned best when it was closest to a free market, and the more we socialize it, the worse it gets. (We have been slowly socializing it for many decades through regulation.) You can argue that we haven't been socializing it "properly," but the way we are doing it is just the way government works in the US, and that's not going to change. In general, we don't…

>The actual experience in the US has been that healthcare functioned best when it was closest to a free market,

When was this?

>the way we are doing it is just the way government works in the US, and that's not going to change.

That's some nice fatalism you've got there.

>In general, we don't have an efficient, honest, effective government, so it can't do anything right on a large scale.

Except for all the things you forget to mention, or even to think of as government programs, because they tick quietly away, working perfectly, in the background.

Re: Why doctors are sick of their profession

#44

Post by venomsnake »

javert wrote: post #42
toasted wrote: post #38

Non-US anaesthesiologist here. I love my job and relish going to work each morning. I spend almost no time on non-clinical paperwork. I work reasonable hours, have some busy on-call shifts but am generally well supported by my department. I earn good money in the state system - enough to raise a family comfortably and have a nice house, but not silly money. I pay no malpractice insurance, but pay $400 annually to a n…

The actual experience in the US has been that healthcare functioned best when it was closest to a free market, and the more we socialize it, the worse it gets. (We have been slowly socializing it for many decades through regulation.) You can argue that we haven't been socializing it "properly," but the way we are doing it is just the way government works in the US, and that's not going to change. In general, we don't…

In US you have socialized the costs. Not the healthcare system. I think the only social type of medicine in US is the VA (they have the purse, their own hospitals and staff IIRC) and last time I read their costs of delivered product were much lower that the US average.

Re: Why doctors are sick of their profession

#45

Post by BenoitEssiambre »

Demographics is huge headwind for doctors. In the past 30 years, median age of the population in North America went from about 27 to almost 40 and is still rising.

Doctors are usually on a fixed fee for service arrangement but every year as people get older, the length of time it takes to perform the average "service" goes up. The amount of time and ressources needed to treat older patients is almost exponential with age. Older patients' state of health is often very complex with all kinds of interactions between illnesses and medication side effects to manage. Sick people get more "services" but also each service takes significantly more time to perform. Yet doctors are expected to be able to perform as many of them each year.

There is an oversized population of people in their fifties right now. This is the age where people start to get sick but are still young enough that they are often the main income earner for their family having one or more dependents.

Doctors have to work more hours for less money trying to help families cope with increasingly common and tragic medical conditions. When a family is collapsing because of an illness and people pile up in the doctor's office (justifiably) in tears, there is no ethical way to "process" these patients in the time that is supposed to be allocated to them.

Re: Why doctors are sick of their profession

#46

Post by forkandwait »

javert wrote: post #42
toasted wrote: post #38

Non-US anaesthesiologist here. I love my job and relish going to work each morning. I spend almost no time on non-clinical paperwork. I work reasonable hours, have some busy on-call shifts but am generally well supported by my department. I earn good money in the state system - enough to raise a family comfortably and have a nice house, but not silly money. I pay no malpractice insurance, but pay $400 annually to a n…

The actual experience in the US has been that healthcare functioned best when it was closest to a free market, and the more we socialize it, the worse it gets. (We have been slowly socializing it for many decades through regulation.) You can argue that we haven't been socializing it "properly," but the way we are doing it is just the way government works in the US, and that's not going to change. In general, we don't…

Downvoted, here is why:

I find your statements to be over general to an almost crazy degree -- "the actual experience"? Everywhere? "In general we don't have an honest effective government" -- really? Got data? Etc, etc.

Also, I would be interested in specific metrics of worse and better -- you make the claim it is worse because of regulation, which you imply is basically the same as socialized funding (which it isn't). So where is the data?

No offense, but this sounds like canned right wing bullshit rhetoric straight off Fox News. Granted, there is plenty of canned rhetoric on all "sides" to go around, but that doesn't make this any better.

Re: Why doctors are sick of their profession

#47

Post by ArkyBeagle »

toasted wrote: post #38

Non-US anaesthesiologist here. I love my job and relish going to work each morning. I spend almost no time on non-clinical paperwork. I work reasonable hours, have some busy on-call shifts but am generally well supported by my department. I earn good money in the state system - enough to raise a family comfortably and have a nice house, but not silly money. I pay no malpractice insurance, but pay $400 annually to a n…

I think it's all about 1945-1950. That's when Truman (accidentally?) ensconced employer-based healthcare into law in the US and the NHS began in Britain. Of course France's solution is quite compelling, as is Germany's, Canada's, Japan's...

The "socialism" thing is just spall from decades of identity politics. Pick apart the propaganda aspects of John Wayne's movies, especially "The Alamo". I'm not snarkin' on Wayne, I love his stuff, partly because it's propaganda.

Our cognitive dissonance is best cognitive dissonance :)

I also have to wonder - if the US actually embraces a public health service would that take the pressure off the public health services of the world to keep cost down?

As economics, it's actually pretty difficult to analyze this issue. The assumptions are formidable.

Re: Why doctors are sick of their profession

#48

Post by forkandwait »

venomsnake wrote: post #44
javert wrote: post #42

Earlier quoted context omitted.

The actual experience in the US has been that healthcare functioned best when it was closest to a free market, and the more we socialize it, the worse it gets. (We have been slowly socializing it for many decades through regulation.) You can argue that we haven't been socializing it "properly," but the way we are doing it is just the way government works in the US, and that's not going to change. In general, we don't…

In US you have socialized the costs. Not the healthcare system. I think the only social type of medicine in US is the VA (they have the purse, their own hospitals and staff IIRC) and last time I read their costs of delivered product were much lower that the US average.

Socialized some of the costs.

Some systems in the US, especially Kaiser, are basically a socialized system supported by premiums, and seem to work pretty well.

Re: Why doctors are sick of their profession

#49

Post by djokkataja »

dobbsbob wrote: post #37

Surprised the average income for a GP is $161,000 in the US, thought they would be paid more than Canadian MDs who's average is $300k http://www.theglobeandmail.com/life/health-and-fitness/healt... Canada also heavily relies on US medical labs in Houston. I had to have a blood analysis done as part of a health check for a work contract years ago and my provincial health authority shipped my samples there for testing.…

A little strange to be comparing American GP average income to the average income of all Canadian MDs given that GPs are paid much less than average.

"Geoff Ballinger, manager of Health Human Resources for CIHI, said the figures represent averages and vary significantly depending on a doctor’s specialty. For instance, the average family practitioner would earn less than a neurosurgeon or cardiologist."

http://www.theglobeandmail.com/life/health-and-fitness/healt...

Re: Why doctors are sick of their profession

#50

Post by ArkyBeagle »

praptak wrote: post #36

All this sounds quite a bit like Marx's theory of alienation: "The theoretic basis of alienation within the capitalist mode of production is that the worker invariably loses the ability to determine his or her life and destiny, when deprived of the right to think (conceive) of himself as the director of his actions; to determine the character of said actions; to define their relationship with other people; and to own…

Just a quick thought but Henry Ford may have found a solution to this. It's also (possibly) been shown that Ford simply had data which showed that transaction costs from turnover made the $5 wage worth his while.

Ford exhibited other bizarre managerial tics, but the world was new-and-all...

Ford's hubris was total vertical integration, but that came later. Detroit is not exactly a worker's paradise today, and few people talk about it...

Marx assumed Malthus, and Malthus could not have anticipated the more modern aspects of mass production and mass agriculture.

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