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The darker side of being a doctor (2017)

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Re: The darker side of being a doctor (2017)

#101

Post by robocat »

nradov wrote: post #67
bsdz wrote: post #30

Something I've never quite understood is why, in the UK, we cap the number of medical students per year. I've known very bright people who aspired to be doctors but had their applications turned down only to go on to do phds and become scientists instead. I'd rather have twice as many doctors who work sensible hours rather than the status quo burn out. Looks like there are calls to change this. https://commonslibrary…

Artificially limiting the supply of doctors is one way of rationing healthcare and holding down costs. Healthcare in the UK is largely funded through the NHS. Voters are already financially struggling and don't want to pay higher taxes. In some cases, even emergency patients are waiting hours in ambulances because hospitals are so overloaded. https://www.bbc.com/news/uk-england-cornwall-68171254

> hospitals are so overloaded

How do you suggest we limit the demand for healthcare?

Re: The darker side of being a doctor (2017)

#102

Post by lazyasciiart »

mlyle wrote: post #76
derbOac wrote: post #61

Earlier quoted context omitted.

The answer is implied, right there in the first paragraph: "... I’ve never been diagnosed with a mental illness." At least in the US, there's a kind of masochistic pride in the physician community, that everything he described in his essay is laudable, noble, to be emulated. Nowhere does he acknowledge the risks to his patients or whether the costs are worth it in the end, or if a different system might be better. An…

> Nowhere does he acknowledge the risks to his patients or whether the costs are worth it in the end, or if a different system might be better c.f. "...everything is rushed, and mistakes are bound to occur." "I am realising more and more that what brings me greatest distress is the relentless administrative pressure which take away the meaningful clinical engagement I have with my patients." "I was burned out and I c…

> which does not have artificial restrictions on the supply of doctors to the same extent

Yes it does. One of the really interesting questions is actually why the same problems have been created in so many otherwise-different systems.

Edit: a post giving details on the Australian medical training constraints https://www.aph.gov.au/About_Parliament/Parliamentary_depart...

Re: The darker side of being a doctor (2017)

#104

Post by flerchin »

317070 wrote: post #79
malux85 wrote: post #17

Earlier quoted context omitted.

What about the meta-game, where doctors get burnt out or suicide, and that increases pressure on the remaining doctors, in a negative feedback loop. We should impose work limits on doctors, just like pilots.

What I don't understand: Say I'm a doctor, and I declare I will only work my 40 hours (or however much a full time is where you are). I will literally leave when my time is up. Oh, and I don't pick up phones outside of work. Or read emails. What will anyone else do about it? Fire me? Then they have even less doctors... It seems to me doctors do have the power to change things, even without collectivizing. But for som…

There's a duty of care* that doctors have. If there's no one else to care for your patient, you're required by law to care for them. (I'm not a doctor, but it's a real thing) It's one thing to risk being fired. It's quite another to lose your profession.

*google "duty of care" for more info

Re: The darker side of being a doctor (2017)

#105

Post by al_borland »

kwhitefoot wrote: post #77
derbOac wrote: post #61

Earlier quoted context omitted.

The answer is implied, right there in the first paragraph: "... I’ve never been diagnosed with a mental illness." At least in the US, there's a kind of masochistic pride in the physician community, that everything he described in his essay is laudable, noble, to be emulated. Nowhere does he acknowledge the risks to his patients or whether the costs are worth it in the end, or if a different system might be better. An…

> At least in the US, there's a kind of masochistic pride in the physician community, But the question is why does the rest of society insist that pilots be properly rested but not doctors? I'm sure a lot of pilots would also work crazy amounts of overtime if allowed.

When a pilot or a truck driver fall asleep, it’s easy to see the cause and effect. When sleeping, they can’t control the vehicle.

With other professions, the people are awake, their brain just isn’t functioning properly, so it’s easier for people to ignore the true cause, since well rested people can make mistakes too.

Re: The darker side of being a doctor (2017)

#106

Post by truculent »

kvonhorn wrote: post #38
bsdz wrote: post #30

Something I've never quite understood is why, in the UK, we cap the number of medical students per year. I've known very bright people who aspired to be doctors but had their applications turned down only to go on to do phds and become scientists instead. I'd rather have twice as many doctors who work sensible hours rather than the status quo burn out. Looks like there are calls to change this. https://commonslibrary…

Supply and demand. If you artificially cap the supply of doctors, then the doctors can ramp up their prices.

I'm not sure this really stands up in a UK context: https://www.nuffieldtrust.org.uk/sites/default/files/styles/...

Re: The darker side of being a doctor (2017)

#107

Post by phren0logy »

robocat wrote: post #101
nradov wrote: post #67

Earlier quoted context omitted.

Artificially limiting the supply of doctors is one way of rationing healthcare and holding down costs. Healthcare in the UK is largely funded through the NHS. Voters are already financially struggling and don't want to pay higher taxes. In some cases, even emergency patients are waiting hours in ambulances because hospitals are so overloaded. https://www.bbc.com/news/uk-england-cornwall-68171254

> hospitals are so overloaded How do you suggest we limit the demand for healthcare?

In the US, anyone can walk into the emergency room for treatment, but people who don’t have insurance are very unlikely to participate in preventative care.

The way to decrease demand For complicated and expensive interventions to preventable problems is to increase access to preventative care.

Re: The darker side of being a doctor (2017)

#108

Post by triceratops »

nradov wrote: post #46
WalterBright wrote: post #28

Earlier quoted context omitted.

The AMA only allows a fixed number of seats in medical school. There also can be tiers of medical doctors. Most doctoring work is routine, and can be handled by a more of a medical tech.

False. The AMA has no regulatory or accreditation authority over medical schools. Schools can admit as many students as they want. The bottleneck right now in producing more US physicians is lack of Medicare funding for residency slots (graduate medical education). Every year some students graduate from accredited medical schools with an MD but are unable to practice because they don't get matched to a residency prog…

> The bottleneck right now in producing more US physicians is lack of Medicare funding for residency slots... Congress hasn't significantly increased funding in years. Much routine care can be delivered by Physician Assistants or Nurse Practitioners working under a Physician's supervision

We should all accept a lower standard of care because hospitals can't find more funding to train doctors? What are all the $20 aspirin paying for? How does every other profession manage to train new members without needing a literal act of Congress?

Re: The darker side of being a doctor (2017)

#109

Post by 317070 »

kwhitefoot wrote: post #93
317070 wrote: post #79

Earlier quoted context omitted.

What I don't understand: Say I'm a doctor, and I declare I will only work my 40 hours (or however much a full time is where you are). I will literally leave when my time is up. Oh, and I don't pick up phones outside of work. Or read emails. What will anyone else do about it? Fire me? Then they have even less doctors... It seems to me doctors do have the power to change things, even without collectivizing. But for som…

They would earn less money. > the power to change things, even without collectivizing. Not really it's a sort of prisoner's dilemma. The one who refuses to work stupid hours gets fired and someone else has their job. If they stood together then it might work.

But there is no one waiting for their job. In most places there is a shortage of doctors.

Re: The darker side of being a doctor (2017)

#110

Post by jstummbillig »

game_the0ry wrote: post #88

I don't understand why doctors that are entering the field need to be over-staffed and over-worked. I have a cousin who is an Er surgeon and she needs works 3 days a week, but that certainly was not the case when she was starting out. The work culture of the medical profession looks horribly inefficient. What benefit do you get from buying out young doctors?

Discipline. (I am not saying it's worth it. I don't know.)
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