Why doctors are sick of their profession • Hacker News Board

Re: Why doctors are sick of their profession

#101

Post by esfandia » Sat, Aug 30, 2014, 10:25 PM UTC

grimtrigger wrote: post #57

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…

The article makes the opposite point - that government bureaucracy (and the mal-incentives it creates) is what is killing the relationships between doctors and patients.

I didn't see any discrepancy: both the article and Marx are criticizing the alienating effect of the added bureaucracy and the lessening of the doctors' autonomy.

Re: Why doctors are sick of their profession

#102

Post by moo » Sat, Aug 30, 2014, 10:32 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…

Your comment reminds me of a book, "Welfare, Ethnicity and Altruism: New Data and Evolutionary Theory". The book looks for empirical evidence for the theory of ethnic nepotism and kin altruism. I don't think I agree with all conclusions but interesting in that the book argues ethnic groupings resist collective programs because they don't want to share with or support other ethnic groups.

Re: Why doctors are sick of their profession

#103

Post by hkmurakami » Sat, Aug 30, 2014, 10:36 PM UTC

the_duck wrote: post #95

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…

Huh. "Belt-phone business guy" is a new expression for me. What does this mean, exactly?

I imagine it literally means "the kind of business guy who has his phone clipped to his belt" (implies a certain kind of caricature of the business/sales archetype).

Re: Why doctors are sick of their profession

#104

Post by dmfdmf » Sat, Aug 30, 2014, 10:39 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…

The doctors lost the argument decades ago when they agreed that people had a right to medical services. It was self-imposed slavery (because they agreed) and now we are just discussing the details (e.g. Obamacare, medicare, etc.) and the govt programs that steal from people to pay for medical services are just windows dressing to make it look civilized and moral.

The good news is that your rights are inalienable, you can reclaim them at any time. The doctors should go on strike and reject the assumption that anyone has the right to their work. As a patient I would support the doctors 100%. Let's see how long medical services last without doctors or how laughable it will be when the govt tries to force doctors back to work. LOL.

Health Care is Not a Right. http://www.afcm.org/hcinar.html

NB: I recently dropped all my medical customers at significant drop in revenue because of HIPPA. You think things are bad now wait until that monstrosity becomes strictly enforced.

Re: Why doctors are sick of their profession

#105

Post by analog31 » Sat, Aug 30, 2014, 10:42 PM UTC

We've all read about how much health care costs in the US, but I'd like to know: Into whose pockets is that money actually flowing? My guess is that those people will be doctors, even if directly caring for patients isn't how they make their money. From what I've gathered by reading about this over the years:

* More than half of doctors are self employed, meaning that their salaries don't tell the whole story about their incomes.

* Doctors are heavily invested as stockholders in provider businesses (insurance, HMO's, etc.), and the malpractice insurance industry. Until recently, my employer-provided health care was delivered by a large organization that was entirely doctor-owned.

Sorry, no links or evidence for either of these, and I think the gathering of that evidence may be difficult due to the complex financial relationships involved. But it makes me skeptical when I read about doctors struggling against "the system." Who owns the system? It may very well be that medical care costs less overseas simply due to a simpler system where costs can actually be tracked. Medicine might become a better profession in the US if med school were free, doctors worked for a salary, and everything else was owned by the government.

To be fair, it may be doctors exploiting doctors, and your career prospects upon finishing medical school may have a lot to do with how much investment money (e.g., inheritance) you have at your disposal to buy into the portion of the business that ultimately profits.

Re: Why doctors are sick of their profession

#106

Post by pinkyand » Sat, Aug 30, 2014, 10:52 PM UTC

jrapdx3 wrote: post #65

pinkyand wrote: post #59

Earlier quoted context omitted.

> The problem is that the industrialization of medicine makes it increasingly difficult to be helpful. Atul gawande, which is a doctor and a healthcare journalist ,and knows the medical system from inside, thinks that industrialized medicine is exactly what's needed: http://www.newyorker.com/magazine/2012/08/13/big-med And in general the positive results from decision support systems seem to agree with him.

Of course, talking about the US health care "system" is hazardous given the enormous diversity of systems within it. No doubt there are instances whereby particular "industrial" implementations function well. But there are also many that function poorly. "Industrialization" is a term that can be applied to mean numerous and distinctly different things. I was referring to situations I've observed where doctors are res…

Yes i agree, sometimes "production" goes too far. In some of those complex case it's even wiser to allocate much more time in advance from doctors and nurses, to prevent future complications - which are much more costly.

But i wonder:

On what sources do you rely when it comes to managing complex cases ? is it only known hard coded medical data in books and databases ? or also some intuition ?

And if it's intuition , how can you form intuition for such complex cases where really each case is pretty unique , as you said ?

Re: Why doctors are sick of their profession

#107

Post by bagels » Sat, Aug 30, 2014, 10:55 PM UTC

dmfdmf wrote: post #104

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…

The doctors lost the argument decades ago when they agreed that people had a right to medical services. It was self-imposed slavery (because they agreed) and now we are just discussing the details (e.g. Obamacare, medicare, etc.) and the govt programs that steal from people to pay for medical services are just windows dressing to make it look civilized and moral. The good news is that your rights are inalienable, you…

"they agreed that people had a right to medical services"

What does this refer to?

Re: Why doctors are sick of their profession

#108

Post by huherto » Sat, Aug 30, 2014, 11:07 PM UTC

alexqgb wrote: post #92

mynameishere wrote: post #83

Earlier quoted context omitted.

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 heal…

Um, you may have missed the point. 1. The thing that distinguishes the values of the Civil Rights era reactionaries is that they're generally failing to transmit themselves from one generation to a next. So unlike the more egalitarian values of the left - which are actually growing stronger with each subsequent generation - the bigotry of the right is uniquely tied to the lifespans of specific people. When they die,…

Do we have evidence that the millennial generation on the deep south also has liberal values?

Re: Why doctors are sick of their profession

#109

Post by e40 » Sat, Aug 30, 2014, 11:12 PM UTC

dmfdmf wrote: post #104

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…

The doctors lost the argument decades ago when they agreed that people had a right to medical services. It was self-imposed slavery (because they agreed) and now we are just discussing the details (e.g. Obamacare, medicare, etc.) and the govt programs that steal from people to pay for medical services are just windows dressing to make it look civilized and moral. The good news is that your rights are inalienable, you…

The doctors lost the argument decades ago when they agreed that people had a right to medical services.

A bold claim without any backup.

Re: Why doctors are sick of their profession

#110

Post by e40 » Sat, Aug 30, 2014, 11:15 PM UTC

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…

There are many great examples of socialised health systems in the world, I'm not sure why the US ignores them?

Because debate in this country has been taken over by assholes and idiots. They lie at every turn to justify their position and they don't care about facts or figures, unless they agree with their ideology.

In my dreams I fantasize about what happened in Portugal regarding decriminalization of drugs. In the current US climate, that could never happen. It bums me out, too.