Why doctors are sick of their profession • Hacker News Board

Re: Why doctors are sick of their profession

#121

Post by phren0logy » Sat, Aug 30, 2014, 11:59 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…

I am also an MD, and I find you embarrassing. The core of medicine is service to others. Granted, we could do a better job of advocating for ourselves, but you are doing it wrong.

Re: Why doctors are sick of their profession

#122

Post by vacri » Sat, Aug 30, 2014, 11:59 PM UTC

nhstanley wrote: post #28

ihsanyounes90 wrote: post #2

In my opinion(and general opinion), this is the most important job. Maybe we can find someone depressed(like in the article), but come on they save lives.

> but come on they save lives. I'm going to say something controversial here, but please bear with me. Your statement sort of encompasses several parts of this problem. Some doctors are miracle workers (see [1] below), but most doctors are glorified auto mechanics. I don't say that to downplay the amount of intelligence/skill required for the job, but if you think of most doctors as "saving lives", then you obviously…

The truth is most doctors get paid a lot because people erroneously assign to them the ethos of miracle workers, when most of them aren't.

They get paid a lot because they have the training to both recognise and know what to do with the edge cases. Yes, the bulk of patients can be treated with the same steps, and the nursing staff can do most of that stuff without problem. But doctors are there to watch for the edge cases, and for odd cases, discuss it with their peers. Regular meetings where doctors go over uncommon issues patients are having - you may not see it when you're on the ward itself, but it's part of the process, spreading the diagnostic load, keeping skills up, and improving outcomes for the patient.

If you really want to help people, you don't become a regular doctor.

A friend's father stopped being a gynaecologist and returned to family-practise GP, because he felt like he could help people better that way, and keep himself more interested in medicine because it was more diverse an environment. In neither environment was he saving lives, but he was still helping people. The two are not synonymous.

Your comment comes off as personally bitter, and I think insulting to folks like GPs who do help people even if they aren't literally saving lives as part of daily practice. You also seem to have conflated 'finding new cures' with 'what a doctor does', the latter of which has a lot of 'applying found cures' to it, and certainly helps people.

Re: Why doctors are sick of their profession

#123

Post by dmfdmf » Sun, Aug 31, 2014, 12:08 AM UTC

tim333 wrote: post #118

dmfdmf wrote: post #104

Earlier quoted context omitted.

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…

>when they agreed that people had a right to medical services ... It was self-imposed slavery... We've had rights to medical services in most of the developed world outside the US for decades. Doctors have high salaries and reasonable conditions for the most part. Funny version of slavery.

Window dressing, as I said.

And how long will this system last when the doctors are extremely unhappy now and things will get worse as the govt takes more control away from the doctors? It should give you some concern that 2mur's sentiment is common today among doctors; "There is no chance I would do it again". Do you think doctors can be replaced by govt bureaucrats following the Code of Federal Regulations? Good luck with that but its where we are headed.

Let me ask you a question: If the doctors went on strike and refused to work, what do you recommend that we do? Do you support the doctors and their right to trade their services on their terms or do you support the demand of the public's "right" to their services?

Re: Why doctors are sick of their profession

#124

Post by joelberman » Sun, Aug 31, 2014, 12:12 AM UTC

I love my primary care doctor who is also my cardiologist. He is amazing. Explains everything, and is never rushed. The only negative is sometimes he is off schedule. I just had open heart surgery and that was also wonderful. The techs, nurses, PAs, and doctors were great. In simple terms, I am thrilled with the care I got and except for one nurse from hell, I have no complaints about care and I have the utmost respect for those who helped me.

Now the dark side. I cannot imagine how many people are preparing bills, sending them to Medicare and then to my supplemental insurance. And how many questions I have about billing and how many phone calls I have to make. I am sure that the cost of administering payments is much higher than the cost of care. And yet none of that administrative work prevents disease or cures me. We need a single payer system and need to reduce the non-care-related paperwork. And let the healers heal.

Re: Why doctors are sick of their profession

#125

Post by joelberman » Sun, Aug 31, 2014, 12:14 AM UTC

I love my primary care doctor who is also my cardiologist. He is amazing. Explains everything, and is never rushed. The only negative is sometimes he is off schedule. I just had open heart surgery and that was also wonderful. The techs, nurses, PAs, and doctors were great. In simple terms, I am thrilled with the care I got and except for one nurse from hell, I have no complaints about care and I have the utmost respect for those who helped me.

Now the dark side. I cannot imagine how many people are preparing bills, sending them to Medicare and then to my supplemental insurance. And how many questions I have about billing and how many phone calls I have to make. I am sure that the cost of administering payments is much higher than the cost of care. And yet none of that administrative work prevents disease or cures me. We need a single payer system and need to reduce the non-care-related paperwork. And let the healers heal.

Re: Why doctors are sick of their profession

#126

Post by dmfdmf » Sun, Aug 31, 2014, 12:19 AM UTC

cmdrfred wrote: post #117

dmfdmf wrote: post #104

Earlier quoted context omitted.

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…

I manage IT for ten dental offices, Hippa isn't that hard (full disk encryption isn't even mandatory). You must not be very good at what you do, and its probably why you are so angry.

You seem to like to make a lot of unwarranted assumptions about my skills and emotional state. Who said I was angry? I made a decision and moved on. I don't waste time on idiocy I can't change. There is plenty of non-medical IT work as I am sure you know, I just didn't want to take on the risks.

FYI, you might want to look into the laws which are just now starting to be enforced. If you are in IT then you are now a covered entity and can be fined directly for HIPPA failures. You also have a legal obligation to document any contact with PHI and you have a legal obligation to report your doctor if you even observe any HIPPA violation, IT related or not. I could not work under these terms so stick to non-medical IT work.

Re: Why doctors are sick of their profession

#127

Post by dmfdmf » Sun, Aug 31, 2014, 12:29 AM UTC

phren0logy wrote: post #121

dmfdmf wrote: post #104

Earlier quoted context omitted.

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…

I am also an MD, and I find you embarrassing. The core of medicine is service to others. Granted, we could do a better job of advocating for ourselves, but you are doing it wrong.

Its not clear how anyone can make someone else embarrassed for views they don't share. I'd have more respect for you if you called me an idiot for my views but your embarrassment at my claims makes me think that you actually know the truth, but lack the courage to rethink it.

> we [doctors] could do a better job advocating for ourselves...

Its all just negotiating the terms of your slavery if you agree that people have the "right" to health care.

Re: Why doctors are sick of their profession

#128

Post by dmfdmf » Sun, Aug 31, 2014, 12:30 AM UTC

bagels wrote: post #107

dmfdmf wrote: post #104

Earlier quoted context omitted.

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?

From the AMA;

> (6) The patient has a basic right to have available adequate health care. Physicians, along with the rest of society, should continue to work toward this goal. Fulfillment of this right is dependent on society providing resources so that no patient is deprived of necessary care because of an inability to pay for the care. Physicians should continue their traditional assumption of a part of the responsibility for the medical care of those who cannot afford essential health care.

Re: Why doctors are sick of their profession

#129

Post by dmfdmf » Sun, Aug 31, 2014, 12:31 AM UTC

e40 wrote: post #109

dmfdmf wrote: post #104

Earlier quoted context omitted.

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.

From the AMA;

(6) The patient has a basic right to have available adequate health care. Physicians, along with the rest of society, should continue to work toward this goal. Fulfillment of this right is dependent on society providing resources so that no patient is deprived of necessary care because of an inability to pay for the care. Physicians should continue their traditional assumption of a part of the responsibility for the medical care of those who cannot afford essential health care.

Re: Why doctors are sick of their profession

#130

Post by FLUX-YOU » Sun, Aug 31, 2014, 12:33 AM 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…

I am so sorry for the quality of Electronic Medical Records software you have to deal with. I realize that software quality probably takes a backseat to the matters in the article, but it certainly can't help when things don't often work and you don't know why and support can't fix it and this affects your care delivery process.