111–120 of 1001 posts
Not surprising. My partner is a DNP and has pretty strongly considered leaving the entire profession. From my perspective, the entire healthcare industry is set up to treat any frontline worker without an MD after their name as completely expendable, nothing more than a row in a spreadsheet that can be optimized for middle management to hit next quarter's bonus targets. You can meet all metrics management sets out fo…
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> How doctors of all professions lost their professional agency to do-nothing administrators within a generation is quite puzzling The profit model of the U.S. healthcare industry might have something to do with it. The fact that hospitals are run like businesses and have shareholders is insane to me. I know other countries' healthcare systems got hit hard by the pandemic too, but it seems like the uniquely capitalis…
If they can't throw some medication with pharma kickbacks at you, they probably won't do much at all. My 6 month old son was put on topical steroids for a small rash on his back and the doctors solution when this turned into a progressive issue was more and stronger topical steroids. Eventually I learned about topical steroid withdrawal, and after a hellish withdrawal period, my son has no real skin conditions. https…
There's just a large range in quality amongst doctors. What you're calling "willful blinders" or "true embodiment of evil" is more likely just a failure to adapt out of a simple paradigm: {Inflammation}->{Treatment = steroids}. And a failure to recognize when that was causing a loop. Maybe they forgot about steroid withdrawal. In fact, as someone with quite an interest in pharmacology and some background as a paramedic, this is the first I've ever heard of it, and I love obscure medication issues.
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I was under the impression that nurses were paid pretty well (generally speaking).
Nurses are paid well, relative to the average American salary. I don't think they're paid particularly well relative to the job's lifestyle requirements and latent stress levels, especially during a pandemic. Looking at my area (NYC), I'd have to take over a 50% pay cut from my engineering job to be "paid well" as a nurse. And I suspect my job is a lot less stressful.
I think the "hardest" job I ever worked was a PC tech support call center or a job at a pizza place. I didn't pick my hours ... and the job was a heck of a lot harder than my coding job that pays WAY more.
But it wasn't like I could just go and get a coding job at the drop of a hat.
Outside of the existing issues with Bedside nursing (long days, physically demanding) - the primary issue is staffing. Pre-pandemic the ratios were already bad but now many are leaving for travel contracts which carry significantly better wages. It quickly becomes a loop where employees leave for Travel Contracts, and then can only be backfilled with Travel Contracts. The remaining FT staff nurses are left making much less money, and have to assist "training" with the outside Travel nurses. And while this is nothing against them - The travel RNs also often have a different "vibe" as they are much less focused on long term improvement or problem solving within the Unit.
Also ICU/PCU/ER nursing throughout the pandemic was a terribly depressing place to be. Leaving many of my Wifes colleagues (including herself) with what is essentially PTSD with little or no support from the Hospital System.
While it's anecdote, every single peer in bedside medical care I know without exception has either left the field, or has immediate plans to as soon as student loan debt is repaid. The few older medical professionals in my family are simply sticking out the last few years until they can retire early. This was generally the case prior to pandemic due to how poor the work environment has become, but the pandemic seems…
Insurance companies. Everything is controlled by insurance companies. You can’t do anything unless it’s exactly how insurance wants and only for what insurance will pay. It limits everything, including how every profession can be compensated simply because you can’t easily hire somebody for more than what insurance will pay for their services. You can, but the funds have to come from somewhere.
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Insurance companies. Everything is controlled by insurance companies. You can’t do anything unless it’s exactly how insurance wants and only for what insurance will pay. It limits everything, including how every profession can be compensated simply because you can’t easily hire somebody for more than what insurance will pay for their services. You can, but the funds have to come from somewhere.
Have US hospitals ever had transparent pricing? This seems like the root of the problem, and insurance seems like what "fixes" that but causes tons of downstream unwanted side-effects.
Most people work for money so I would take all this with a grain of salt. If you are a RN what are you going to do if not nursing? The same applies to all fields including Physicians.
Salary for nurses varies widely, and in some places, they're wage-competitive with Amazon delivery drivers now. I can easily see people deciding that even though they like helping folks, getting paid less than the people who drive around and drop packages all day doesn't seem like a fair deal.
While it's anecdote, every single peer in bedside medical care I know without exception has either left the field, or has immediate plans to as soon as student loan debt is repaid. The few older medical professionals in my family are simply sticking out the last few years until they can retire early. This was generally the case prior to pandemic due to how poor the work environment has become, but the pandemic seems…
> How doctors of all professions lost their professional agency to do-nothing administrators within a generation is quite puzzling and a bit terrifying to me. I have a lot of friends at various levels of healthcare, from nursing up through low and mid-level administrative positions. The one thing they all seem to agree on is that patient satisfaction surveys have been terrible for healthcare. Once the emphasis shifte…
It's clear from your comment that the source of the problem is the increasingly sharp divide between what the credentialed medical professionals believe and what lay people believe. The satisfaction survey is simply uncovering that fact.
It would be vastly worse if patients were being treated and had no recourse when they felt their health was mismanaged. It may well be the case that the patients are wrong, but it is extremely dystopian to imagine a world where individuals are not empowered to make decisions about their own bodies.
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Insurance companies. Everything is controlled by insurance companies. You can’t do anything unless it’s exactly how insurance wants and only for what insurance will pay. It limits everything, including how every profession can be compensated simply because you can’t easily hire somebody for more than what insurance will pay for their services. You can, but the funds have to come from somewhere.
Insurance is the only industry where they agree to pay for something (in this case, "medical care"), but then after service has been rendered can decide to pay less, or not pay at all, or stop paying that provider altogether, etc. This combined with hospitals being run by non-physicians*, and people thinking being able to Google and read WebMD qualifies them to argue with their doctor about treatment plans**, healthc…