Why doctors are sick of their profession • Hacker News Board

Re: Why doctors are sick of their profession

#171

Post by Mvandenbergh » Sun, Aug 31, 2014, 12:00 PM UTC

jval wrote: post #164

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 problem is that the United States isn't a 'country' in the way the UK, or Denmark, or Australia is. The entire population of Denmark is 5.59 million, the size of a single second or third tier city in the US. Australia is 22 million, the size of the NYC metro area. You can socialise and centralise healthcare in countries on such a small scale, but it becomes exponentially more difficult to do in a country like the…

Healthcare is administered regionally, by the NHS trusts, in the UK.

Also, Germany is a federal country of 80+ million people, that's surely a better comparison than Denmark.

Re: Why doctors are sick of their profession

#172

Post by doctorKrieger » Sun, Aug 31, 2014, 12:09 PM UTC

jval wrote: post #164

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 problem is that the United States isn't a 'country' in the way the UK, or Denmark, or Australia is. The entire population of Denmark is 5.59 million, the size of a single second or third tier city in the US. Australia is 22 million, the size of the NYC metro area. You can socialise and centralise healthcare in countries on such a small scale, but it becomes exponentially more difficult to do in a country like the…

so why don't you socialise the healthcare at the state level? Most EU countries have social healthcare which is working.

Re: Why doctors are sick of their profession

#173

Post by Mvandenbergh » Sun, Aug 31, 2014, 12:12 PM UTC

jasonisalive wrote: post #162

toasted wrote: post #159

Earlier quoted context omitted.

NZ

Keep in mind that, well-paid and satisfied specialists aside, there is another side to this picture - important to remember with state-run healthcare systems such as NZ, so often a poster child for socialist policy. For example this IT department head of a major district health board who embezzled ~$17 million dollars over a period of 6 years, with which to buy, among other things, luxury vehicles. http://www.odt.co.…

You... can't imagine embezzlement happening in the private sector?

That's bold.

Re: Why doctors are sick of their profession

#174

Post by mariodiana » Sun, Aug 31, 2014, 12:29 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…

"really horrible, angry, violent, and generally racist people"

Seek help.

Re: Why doctors are sick of their profession

#175

Post by VLM » Sun, Aug 31, 2014, 12:37 PM UTC

jval wrote: post #164

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 problem is that the United States isn't a 'country' in the way the UK, or Denmark, or Australia is. The entire population of Denmark is 5.59 million, the size of a single second or third tier city in the US. Australia is 22 million, the size of the NYC metro area. You can socialise and centralise healthcare in countries on such a small scale, but it becomes exponentially more difficult to do in a country like the…

"50 separate state governments"

I'm not understanding the problem here. Run "git clone" on the Canadian model fifty times. All done.

Furthermore we seem to have "no problem" scaling up central federal control of seemingly everything other than health care, so a comparative explanation would seem necessary, as to why federal social security is possible or federal OSHA or federal EPA or federal militarized police or the federal military itself, but for no provided reason federal health care would be impossible to scale.

Re: Why doctors are sick of their profession

#176

Post by mariodiana » Sun, Aug 31, 2014, 12:49 PM UTC

healthisevil wrote: post #156

I am a physician in Australia. Being a doctor sucks here too. I encouraged my son to avoid medicine. He followed my advice and is enjoying himself in private equity. Anyone bright enough to do medicine would do far better in another profession.

"Anyone bright enough to do medicine would do far better in another profession."

Just as a point of reference, I'm in the U.S. and not a doctor. But I've always seen careers in medicine as a kind of social scam. Not necessarily a bad one, but there is or was something funny going on.

A person smart enough to be a doctor could be many things and earn a lot more money doing one of those things. The only thing society can really offer doctors is independence and respect. That's why -- for the longest time in this country -- doctors often owned and ran their own practices. That's why we addressed doctors with the honorific "Doctor." But the first is all but dead in this country and the second, because of some kind of unwashed, egalitarian ethic that only gets worse and worse, is starting to die out too.

We've really fucked up, as a society. No one in his or her right mind is going to want to spend life kow-towing to pervasive regulations and third-party bureaucrats second guessing them and tying their hands, while rushing to and fro like a retail clerk in an understaffed big box store, and all the while having to protect the egos of patients by introducing oneself as Bob or Sally.

Doctors need prestige and independence. Without those, the lure of "doing good" just isn't enough to convince anyone to become one -- at least, not anyone I'd want to have to trust as a patient.

Re: Why doctors are sick of their profession

#177

Post by Bootvis » Sun, Aug 31, 2014, 1:38 PM UTC

jasonisalive wrote: post #165

Bootvis wrote: post #163

Earlier quoted context omitted.

That's unfortunate but the bottom line for patients is that the NZ works excellently. Sure, it sucks that someone committed fraud and got rich in a dishonest manner but preventing that is not the goal. In the end, this fraud doesn't really affect the healthcare given.

NZ works excellently. That is a pretty big claim... Have you ever actually lived in NZ and experienced the realities of paying for this system via taxes and claiming its services? Have you monitored the incessant demands for more services at better quality, the incessant complaints about being over-worked and underfunded, the endless criticisms and debates about inefficiency, long wait times, burdensome bureaucracy,…

You're not afraid of making some pretty big claims yourself. Wikipedia[1] supports my claim that while the situation might not be perfect it works quite well and that's the most important thing. Compared to other countries, the US in particular, the NZ healthcare system delivers good results. Which in my view makes it excellent.

Then what about the negative aspects you mention. Well, in the Netherlands we have a similar system and to be honest I don't care about all the whining you mention. Sure, people complain and things probably can be better. There is always room for improvement. Unfortunately people will complain about healthcare if they stub their toe. Fuck 'em, you can't stop these people from complaining and policy should not accommodate their every whim.

Can you support your claim that bad things happen and go unpunished

> when a society decides to sever the act of consumption from the actual purchase of a service.

I'm not feeling them, my family is not feeling them and my MD friends are happy with their jobs. And don't forget: the private sector is still an option so there is a choice.

[1]: http://en.wikipedia.org/wiki/Health_care_in_New_Zealand

Re: Why doctors are sick of their profession

#178

Post by disputin » Sun, Aug 31, 2014, 1:39 PM UTC

moo wrote: post #102

alexqgb wrote: post #63

Earlier quoted context omitted.

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.

I'll be taking a look at that, thanks. In London I find the majority of diversity has little integration, instead each nationality gathers in a location and forms an insular "community" mostly detached from the others, which seems to miss the point. I've met people who've been here for 20 years yet can't speak English due to that insularity. Members of nationality X walking 25 minutes to get a nation X pizza, rather than the Italian pizza five minutes away, only buy nation X products, only from nation X shops, nation based employment, nation based music lessons, and so on. Some preference, practicality, or nostalgia is understandable, but it's beyond that. There's polarization, which worsens when there's some form of stress. There's no discussion of it because because there's fear of accusations of racism in what's become a sort of racism witch hunt. The UK news has recently been filled with news of a Pakistani child sex grooming gang, but the media seem to be referring to them as Asian, which not only is sufficiently vague that they may as well be saying that they're from the northern hemisphere, but it also strikes me as even more divisive to be categorising an entire continent. Ethics and ideologies aside, I'm interested in the mechanics and where it can and where it is unlikely to succeed.

Re: Why doctors are sick of their profession

#179

Post by busyant » Sun, Aug 31, 2014, 1:46 PM UTC

lutusp wrote: post #91

georgemcbay wrote: post #88

Earlier quoted context omitted.

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, IM…

> I'm a leftie socialist tree-hugger American who thinks taxes (on the wealthy and corporations) need to go up quite a bit... I agree with that idea, but guess who also agrees ... billionaire Warren Buffet. http://www.nytimes.com/2011/08/15/opinion/stop-coddling-the-... Quote: "My friends and I have been coddled long enough by a billionaire-friendly Congress. It’s time for our government to get serious about shared s…

Well, Buffet is in the process of engineering movement of Burger King to Canada in part b/c of tax considerations.

> who thinks taxes (on ... corporations) need to go up quite a bit...

Many US-based organizations are trying to establish HQ in places like England and Ireland b/c of tax advantages. e.g., Pfizer tried recently and AbbVie (another pharmaceutical giant) is in the process of doing so.

Re: Why doctors are sick of their profession

#180

Post by chelch » Sun, Aug 31, 2014, 1:57 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…

It's not as simple as the right-wing boomers dying. There are a few things we need to keep in mind: - People become more conservative as they age. - The political right receives more support from crony capitalists. - Crony capitalism is what's causing problems for these doctors in the first place.

It's happening all over the world. There's a general trend where the right-wing trolls are aligning themselves with the cronies. While the next generation wants to fight the nastiness in racial/sexist/homophobic discrimination, they're not too enthusiastic about doing anything besides paying lip service to structural problems in the way the world works economically.