Why doctors are sick of their profession • Hacker News Board

Re: Why doctors are sick of their profession

#81

Post by ArkyBeagle » Sat, Aug 30, 2014, 8:29 PM UTC

[deleted] wrote: post #75

ArkyBeagle wrote: post #72

Earlier quoted context omitted.

So we can't but Canada can? As straining-of-credulity as such a bumper-sticker is, isn't that the logical conclusion? Very Serious People ( with whom I happen to agree) actually say such things in "Fragile By Design". Calomiris/Haber are good writers and good thinkers. They do not call out medical nor political leadership there, but it's not exactly a stretch. It's a short drop from this to the view of America from "…

[deleted]

Very good point - although you'd think it would be possible to have models and feedback for models that would scale.

I expect the "higher GDP" tells us a lot. I first discussed this with my Dad when we took one of us the the Emergency Room for stitches ( it just wasn't a summer as a kid without a bike wreck or something leading to stitches ) and I was shocked by the bill - in 1972.

I'd be pressed to find the reference, but people have shown that proportional percent of income ( in the aggregate, GDP ) spent on medical care has been consistent between countries.

I hold that employer-based health care has turned out more sour than it perhaps once was because employment has gotten weirder. That arguably was not true in, say 1950. But medicine was also smaller then.

Re: Why doctors are sick of their profession

#82

Post by ArkyBeagle » Sat, Aug 30, 2014, 8:30 PM UTC

k-mcgrady wrote: post #54

exstudent wrote: post #10

You can definitely feel this as a patient. If I could give my vitals to an app and have it diagnose and prescribe remedies, I would do it in a heart beat and never visit a doctor again (of course you would need robot surgeons too :). I've never seen a doctor research anything either (although I'm sure they do behind the scenes). They seem to be pulling from whatever information cache they have in their head which I o…

>> "I've never seen a doctor research anything either" I have. It's terrifying. I recently went to the GP, told them my condition (which had been diagnosed by a different GP) and their first response was to look it up on Wikipedia. Seriously. I understand that a GP isn't going to know every condition you come in with but Wikipedia as the reference material?

You can always tell the premeds as an undergrad - they are the ones who ask "will this be on the test?"

Re: Why doctors are sick of their profession

#83

Post by mynameishere » Sat, Aug 30, 2014, 8:33 PM UTC

alexqgb wrote: post #63

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…

It's not true to say that the US, in general, ignores these systems when in fact, a significant portion of the US population pays very close attention to them and would like nothing more than to seem them implemented here. There is, however, a significant minority of really horrible, angry, violent, and generally racist people who feel deeply and ideologically threatened by the social contract on which these systems…

Dude, chill. Not to intrude on your fantasy world too much, but a few things:

1. The left wing of the baby boom is going to die with the right.

2. The baby boomers were famously a bunch of hippies and radicals. More seriously, they were easily the most liberal-minded generation in America at the time--and they may still be.

3. This country's ongoing demographic transformation into Brazil is not going to help the health care system, or move us toward a "more perfect union", or do anything at all positive in general. It baffles me that people think things like that.

Re: Why doctors are sick of their profession

#84

Post by 2mur » Sat, Aug 30, 2014, 8:53 PM UTC

I'm a physician. I love the value I bring to patients, and I enjoy what I do (most of the time). But the industry is disgusting. The people who are creating the real value for patients (nurses, technicians and doctors) have been saddled with increasing regulations and there are incredibly levels of administrators and belt-phone business guys riding them to extract every profit out of the environment.

There is no chance I would do it again.

Re: Why doctors are sick of their profession

#85

Post by a3n » Sat, Aug 30, 2014, 8:59 PM UTC

mikeleeorg wrote: post #66

Many friends of mine are doctors and they've expressed the same feelings. There are days when they absolutely love what they do, but as an outsider, I see them experiencing more low days than high days. Just as an anecdote, part of it is the expectations of the patient population in the Bay Area - and I'm only referring to the high income neighborhoods here; the situation differs significantly in low income neighborh…

> A lot of doctors translate this to a lack of respect, which echoes the quoted statement in the article.

Does this mean a lack of general respect, the type that all people deserve? Or is this some kind of extra respect and dererence due to their education or profession, which no one deserves?

Because I am constantly disrespected by the medical profession. I am sent email a day or two before each appointment, reminding me that late or canceled appointments are subject to cancellation fees, yet I have NEVER been seen on time by any doctor ever.

Re: Why doctors are sick of their profession

#86

Post by chrisbennet » Sat, Aug 30, 2014, 9:05 PM UTC

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…

At my doctor, the nurse takes my blood pressure and then then my doctor takes it again when he first sees me.

Re: Why doctors are sick of their profession

#87

Post by infogulch » Sat, Aug 30, 2014, 9:05 PM UTC

2mur wrote: post #84

I'm a physician. I love the value I bring to patients, and I enjoy what I do (most of the time). But the industry is disgusting. The people who are creating the real value for patients (nurses, technicians and doctors) have been saddled with increasing regulations and there are incredibly levels of administrators and belt-phone business guys riding them to extract every profit out of the environment. There is no chan…

Are you a cancer doctor by any chance?

Re: Why doctors are sick of their profession

#88

Post by georgemcbay » Sat, Aug 30, 2014, 9:05 PM UTC

GreenPlastic wrote: post #62

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…

In order to understand the US, you have to go back to the formation of the country. The US was started because of distrust in the British government. The constitution was setup on a system of distrust, not trust. As such, mistrust of social systems and government is deeply ingrained in US culture. Contrast this to Scandinavian countries or European countries who fundamentally trust the government.

I'm a leftie socialist tree-hugger American who thinks taxes (on the wealthy and corporations) need to go up quite a bit... but I still think a system of distrust is the way to go, because humans, while generally more good than evil, are inherently selfish and flawed and can too easily rationalize injustice in the face of personal gain and that makes them worthy of distrust, especially when organized.

The problem, IMO, isn't that we set up a system of distrust, but rather that we allowed the checks and balances (originally placed in the system to keep balance) to erode over time so now we have a negative feedback loop where our distrust of our own government is growing ever stronger, but for pretty good reasons (regardless of which "side of the aisle" you are on) -- unrestricted lobbying, mostly unrestricted campaign finance and lack of meaningful term limits on too much of our government increases power imbalance and thus distrust with no counterbalances to allow people to take back any power from the system that is now spinning out of control.

At this point the game is basically lost, I think, and we're just stuck sitting back and watching what happens as the system collapses over the next couple of decades. Hopefully it'll go a bit better than that "Collapse Gap" analysis suggested it will.

Re: Why doctors are sick of their profession

#89

Post by hkmurakami » Sat, Aug 30, 2014, 9:16 PM UTC

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…

My primary care physician and my neurologist both would personally take my readings and do even the most basic of exams themselves. They were extremely thorough, and had the utmost respect for their patients. Maybe this was the case because they were both 60+ years of age and had their own practices -- maybe this allowed them to buck the trend by having established their business before things got really bad.

They both retired earlier this year, and I am like a lost child again, having had so much trust in these two doctors :(

Re: Why doctors are sick of their profession

#90

Post by johan_larson » Sat, Aug 30, 2014, 9:17 PM UTC

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…

There is very little about the health care industry, at any level, that is "free market". The government funds much of the basic research that generates new medicines and medical devices and then regulates which ones can be sold. It works hand in hand with medical professional associations to determine who can practice medicine and in what capacity; it also funds residencies, the crucial gateway to becoming a physician. It pays for a hefty portion of medical care (for the young, the old, the very poor, and veterans) directly and regulates how the rest is paid for (out of pocket, through employer-provided insurance, or privately purchased insurance).

There are a few islands of private industry in healthcare, but between the regulation and the direct payments, it's a government sea.

Barring the most radical dissolution of the current system, the question isn't whether the government should be involved, but how.