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Why doctors are sick of their profession

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Re: Why doctors are sick of their profession

#151
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…

It's not a free market if you're forced to participate in it. Which we all are, by virtue of being alive.

You mean like food, housing, etc? Free markets don't mean they're optional, it means that participants interact freely and voluntarily.

Re: Why doctors are sick of their profession

#152
post #104
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…

Put the book down, John Galt.

Re: Why doctors are sick of their profession

#153
post #148

Earlier quoted context omitted.

> I'd have more respect for you if you called me an idiot for my views Well, since you're inviting personal criticism, then, and suggesting it might engender more respect for critics and their opposing points than a doctor weighing in on your position... It'd seem that you suffer from all-or-nothing, black-and-white thinking -- that when confronted with tension between two ideals you don't know what to do except pick…

>...than a doctor weighing in on your position... As smart as they are, the doctors are most clueless regarding the moral issues involved. There is another MD in this thread claiming the essence of medicine is service to others but I think 5 minutes of thought can dismiss that non-sense, even from a doctor. > It'd seem that you suffer from all-or-nothing, black-and-white thinking -- I don't consider this a flaw in my…

In most western civilizations government food assistance and other nutritional aid are available for those who would otherwise starve to death. Given that the only estimate I found of actual starvation deaths in the United States was 140 in 2004, I think we can say that people in the United States have a right to basic amounts of food.

Re: Why doctors are sick of their profession

#154

Earlier quoted context omitted.

It's not a free market if you're forced to participate in it. Which we all are, by virtue of being alive.

You mean like food, housing, etc? Free markets don't mean they're optional, it means that participants interact freely and voluntarily.

Not really. Every human being can survive with the same minimal allotment of food and housing, but that's not true of health care. Some people will use very little while some will use a lot more through no fault of their own.

Re: Why doctors are sick of their profession

#155
post #148

Earlier quoted context omitted.

> I'd have more respect for you if you called me an idiot for my views Well, since you're inviting personal criticism, then, and suggesting it might engender more respect for critics and their opposing points than a doctor weighing in on your position... It'd seem that you suffer from all-or-nothing, black-and-white thinking -- that when confronted with tension between two ideals you don't know what to do except pick…

>...than a doctor weighing in on your position... As smart as they are, the doctors are most clueless regarding the moral issues involved. There is another MD in this thread claiming the essence of medicine is service to others but I think 5 minutes of thought can dismiss that non-sense, even from a doctor. > It'd seem that you suffer from all-or-nothing, black-and-white thinking -- I don't consider this a flaw in my…

As you have invited personal criticism: You are naive and your thinking is simplistic. You have managed to get away from complete naivete, you think using abstract concepts, which allows you to look through the superficial appearance of things, and thus cut through a lot of bullshit. But you haven't noticed yet that your abstractions are way too abstract to give a reliable representation of the real world by themselves, that abstractions are just helpful thinking tools, but not the full truth - and that because of that your way of thinking produces about as much bullshit as it cuts through, just of a different kind.

In particular, it's seldom helpful to cling to specific terms and their supposed definitions rather than look at the actual facts. Who cares whether doctors are slaves? Is there anyone who has any actual disadvantages due to how the system works or not? If everyone, including the doctors, is better off with how the system works, who cares whether they are slaves by some definition? If they have some disadvantages, then that should be addressed, who cares whether it fulfills the criteria for being a slave?

Also, you always have to consider the wider societal context. There might be indirect benefits outside the immediate transactions that arise from how a society is constructed. Where I live, for example, if you see someone in distress and there is no significant danger to you if you were to rescue them, and you are able to, it is a criminal offense not to help. I guess by your standards that would mean we are all slaves - but I think the democracy that created the law is perfectly sufficient to justify this obligation, which as a side effect presumably generates higher safety and a higher sense of safety for everyone.

Re: Why doctors are sick of their profession

#157

Earlier quoted context omitted.

You mean like food, housing, etc? Free markets don't mean they're optional, it means that participants interact freely and voluntarily.

Not really. Every human being can survive with the same minimal allotment of food and housing, but that's not true of health care. Some people will use very little while some will use a lot more through no fault of their own.

You're still free to choose who you get healthcare from.

It's like saying the food/farming industry isn't a free market because "some people will use very little while some [fat people] will use a lot more through no fault of their own." It's a ridiculous argument, and sounds more along the lines of Peter Joseph's "structural violence" mantra. The whole "you're not truly free until you get all this free shit given to you so you can be free to do nothing/be lazy".

Granted, it isn't actually a truly free-market, anyways. Government subsidies, minimum prices, etc, all distort the market and affect peoples' actions.

Re: Why doctors are sick of their profession

#158
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…

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'…

"Granted, there is plenty of canned rhetoric on all "sides" to go around, but that doesn't make this any better."

The problem is that certain sides get way less flak for "canned rhetoric". Particularly populist viewpoints.

Re: Why doctors are sick of their profession

#159
post #40
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…

In which country do you work as an anaesthesiologist?

NZ

Re: Why doctors are sick of their profession

#160

Earlier quoted context omitted.

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 ,…

The ancient wisdom is the practice of medicine is as much art as science. There is "evidence" supporting many practices. As in every complex endeavor, evidence is not static, but evolving constantly. Evidence is necessary but by itself insufficient. We must use our own power of observation combined with what we know and what we've learned to decide what to do. So your question is indeed profound, cuts to the core of…

> Who said decisions should be easy? I sweat over each and every one.

True medicine is a really hard job.

So maybe the way decide in medicine should be changed ? maybe they be done remotely but through a recommendation system so that each doctor would get plenty of nearly similar cases - so he could practice and hone it's intuition ?

Or since the complexity is really too great (and as a patient hearing that "this is art not science" isn't that encouraging , even if true) maybe the overarching goal of medicine should be to remove the art, and we finally have the tools to do it(watson, machine learning ,remote diagnosis , etc...) ?

And if we agree that that's a good goal, maybe the current way we try to do it (evidence based medicine) , is a bit clumsy due to both the science and the resistance by doctors , but at least it's going in the right directorion.

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