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Why doctors are sick of their profession

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Re: Why doctors are sick of their profession

#211
post #203

Earlier quoted context omitted.

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 themselv…

This a wordy and intellectually sounding repudiation of reason, nothing more.

If you seriously believe that, you are indeed being an idiot.

Your logic reasoning skills may be pretty good, which is a component of reason that many people lack. What you seem to lack is a useful mapping between reality and propositions. And from false premises, unfortunately, even flawless logical derivation cannot produce any useful information about the world.

When wwweston critizes your black-and-white thinking, he is not suggesting (I think) that there is some kinda-maybe-not-quite-true-or-false truth value. Rather, he suggests that the choices you are implying actually have more than two mutually exclusive possibilities. In particular, words don't actually have "real meaning", words routinely have tons of meanings, heavily depending on context, which is why you cannot make a simple binary decision as to whether something is or is not an X. It's somewhat unfortunate, as that leads to lots of confusion, but there is nothing logically wrong with it, it's simply a matter of fact that one has to consider when one wants to construct sound arguments, so as to never equivocate any two different meanings of the same word. The binary determination is only possible either for cases which evaluate to the same truth value with every conceivable definition of a word, or once you pin down the exact meaning that is intended in a given context.

Part of the problem with your arguments indeed seems to be equivocation. There is a definition of slaves that hinges on complete unfreedom, which is roughly what most people think of if you don't specify any specific definition - let's name that a slave1 for the purposes of this discussion. Then, there are definitions based on certain philosophical arguments that try to show how, for example, socialism produces similar power structures to "traditional" slavery in certain regards, we'll call that a slave2. (Similar arguments exist for capitalism, and many other power structures.) Now, you come along and say "requiring doctors to provide a service is making them a slave2", which is actually a perfectly reasonable statement to make - except you obviously imply "which is the same as a slave1, and everyone knows that being a slave1 is bad, therefore, requiring doctors to provide a service is bad", and that's just an equivocation fallacy that you employ to avoid having to justify why one is as bad as the other, where that is not the slightest bit obvious if you look at the actual circumstances that slave1s lived in and that doctors live in nowadays.

Re: Why doctors are sick of their profession

#212
Is Obamacare going to be the first step towards making the U.S. a socialist country ? Is the true goal to reditribute wealth ? It is meant here, http://www.mymustardseeds.com/ultimate-goals-of-obamacare.ht....

Or is it just verbiage to shine for the next election ?

Will people suffer from Obamacare ? Are consequences to the whole system really under control (increase of the premiums, ...) ?

Re: Why doctors are sick of their profession

#213

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.…

I expect there'd actually be more fraud under a free market system because catching fraud (past a certain point) is expensive and companies are only going to put the resources into catching fraud if it continues to exhibit a positive ROI. Or maybe NZ bureaucrats are insulated and dedicated enough to do the right thing rather than listen to the outrage of the voters when fraud makes the news, but I wouldn't expect that to be true in the US.

Re: Why doctors are sick of their profession

#214
post #51

Earlier quoted context omitted.

> 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…

Practicing medicine for decades gives me some "perspective" on the subject. No one in medicine is a "miracle worker", though many of us work hard to the job responsibly. You are wrong. We do "save lives", and not just in the ED. Every day, if not as dramatically, immediately or even noticeably, our incremental toil helps patients progress bit-by-bit toward better health. Managing chronic, debilitating conditions real…

> For example, amazingly short-sighted insistence on paying for a "generic" medication $3/mo cheaper than the drug already working is an every day challenge.

Pardon my ignorance, but aren't generics chemically-identical compounds that simply don't carry the brand name? My "generic replacement for Norco" is still acetaminophen and hydrocodone. Indeed, the Wikipedia article on generics notes that "A generic drug must contain the same active ingredients as the original formulation", and that it must be "comparable in dosage form, strength, quality and performance characteristics, and intended use".

What am I missing that makes generics a problem?

Re: Why doctors are sick of their profession

#215
Most important takeaway (other than a series of anecdotes, a general history lesson, and a few random undefended policy suggestions):

"In 1940, in inflation-adjusted 2010 dollars, the mean income for U.S. physicians was about $50,000. By 1970, it was close to $250,000—nearly six times the median household income."

Re: Why doctors are sick of their profession

#216
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 issue is more complicated than just socialized vs. non-socialized. There are many countries with privately run healthcare system that are perfectly good, such as France or Switzerland. And there are countries that combine both public and private provision of healthcare and have it work perfectly well, such as Sweden or Singapore[1]. The US actually does run some hospitals directly, the VA, and I doubt this made t…

This is the best explanation of the healthcare problems the US has that I've seen in a while. It's not a "public vs. private" thing in the US that is the problem. It's a byzantine system of patchwork laws that have tried to make the system better, but only made it worse. It's so complicated now that it'll take a hell of a lot of work to fix it.

Re: Why doctors are sick of their profession

#217

Earlier quoted context omitted.

New Yorkers aren't going to "pay for Idaho". NY may be paying more in tax for the entire state, but their budget would also be much larger. For obvious reasons NY can be more efficient, but that doesn't mean that they'll be paying a significant amount of the budget in Idaho.

Well, actually, they would, for the same reasons that the postal service will make money in populated areas and lose money in less populated areas. Say you need a trauma center within 1 hour of anywhere in the country. A trauma center in Manhattan is going to see a lot of traffic, while one in Clayton, NM, isn't. But the centers have the same basic cost in staff and gizmos.

It's not a once size fits all. You would of course look at the size of the area and the amount of traffic. So areas with higher traffic would get more resources allocated.

The real problem with healthcare is that you can never have enough. Even if everyone paid 100% in taxes it wouldn't be enough.

Re: Why doctors are sick of their profession

#218

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 c…

> A person smart enough to be a doctor could be many things and earn a lot more money doing one of those things.

Is that really true? Doctors are most of the best-paying jobs in the US [0] It seems to me that if you're bright, and care about making a lot of money, medicine is absolutely the way to go. Yes, there are some people who strike it rich with startups or high finance, but that's essentially buying a lotto ticket.

[0]: http://www.bls.gov/oes/current/oes_nat.htm#00-0000 (sort by annual mean wage, Anesthesiologists, Surgeons, Oral and Maxillofacial Surgeons, etc.)

Re: Why doctors are sick of their profession

#219
post #157

Earlier quoted context omitted.

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…

I hear what you're saying and agree in part, certainly where things other than health care are concerned. Both sides of the argument are deeply flawed. The fact remains, though, that we in the US pay more for our health care and get less in return for it than residents of countries with real "socialized medicine." We are indisputably doing it wrong. We owe it to ourselves to consider the problem more deeply than we can by comparing it to traded commodities like food and housing.

Re: Why doctors are sick of their profession

#220
post #186

Earlier quoted context omitted.

"really horrible, angry, violent, and generally racist people" Seek help.

The language is a bit exaggerated but I don't think it deserves such an offensive dismissal. There is plenty of evidence that conservatives have those traits, not to mention that it is a widely held belief, which is enough to make it an acceptable comment. See for example http://faculty.virginia.edu/haidtlab/jost.glaser.political-c...

I don't know any conservatives. (I work in tech and live in SF). They sound like truly horrible people. I'll keep a sharp eye out for them in the future. Your link is great! Two of the authors are from Berkeley, where I went to school!
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