Earlier quoted context omitted.
The solution is automation.
Yup, we just need a startup that makes Robotic Surgeons and Nurses. Easy peasy.
I'm not arguing that it's possible now, but then, we face a lot of problems without immediate solutions.
Medical school can be brutal, and it’s making many of us suicidal
121–130 of 170 posts
Re: Medical school can be brutal, and it’s making many of us suicidal
#122My wife finished medical school a bit over 4 years ago. While she thought medical school was brutal, it was comparatively easy compared to the challenges she faced in residency (she did her prelim at UCLA-Harbor and is now at Boston Children's hospital doing pediatric neurology). 80+ hour work weeks are the norm, and sometimes she works 14 days straight and has a pager that beeps throughout the night that she must re…
Yup. My wife is a neurosurgery resident. While she's on her research year right now, which is comparatively relaxed[1], prior to this she worked 5 years of 80+ hour weeks, including three stretches of 20+ consecutive days after another resident in her program left. Looking back on medical school, she can't believe how ridiculously easy it was and how much free time she had. [1] where "comparatively relaxed" still mea…
To what end? It's well known the body has Unless they get paid by the hour, I see no reason to continue to participate in such a system. Still, it should not be allowed when lives are at stake.
Re: Medical school can be brutal, and it’s making many of us suicidal
#123Earlier quoted context omitted.
> especially when it comes to employment discrimination I mean, a lot of mental illnesses actually have a legitimate negative effect on one's ability to be a productive worker. It wouldn't really make sense to make it illegal to discriminate against people with e.g. severe learning disabilities who can't read or write.
> I mean, a lot of mental illnesses actually have a legitimate negative effect on one's ability to be a productive worker. Yes I completely agree. However, if a mentally ill person can perform their duties with reasonable accommodations as well as a person who isn't mentally ill , then that person shouldn't be discriminated against. Indeed, the Americans with Disabilities Act already covers people with depression and…
> it's still unethical
Not sure I agree with you there. Personally, I think all business interactions should be voluntary; anything else is slavery with a few palliative layers of abstraction thrown in.
In the particular example you gave, that's just foisting part of the cost of reproduction (risk of productivity loss) onto some innocent third parties.
I see both sides of the argument, and I see why protecting the convenience of reproduction is important from a practical genetic/memetic standpoint, but I wouldn't go so far as to call it "ethical".
Re: Medical school can be brutal, and it’s making many of us suicidal
#124medical school is humbling and difficult. Being a physician is difficult. I finished medical school in 1996 - didn't find it ridiculously hard, but then again, studying a lot was what I did in my youth. Now, I'm 47 years old, and work about 90 hours a week as a surgeon - I laugh when people say that we make too much. All I know is that 25 years ago, you had to be in the top 10% of your class to become a surgeon. When…
> I'm 47 years old, and work about 90 hours a week as a surgeon
Sorry, you and your industry should be ashamed of themselves for putting lives at risk. Mistakes from fatigue are a real thing. Maybe you are just cutting off bunions, but there still could be complications.
Re: Medical school can be brutal, and it’s making many of us suicidal
#125> "I checked the medical licensing requirements in California to make sure I wouldn’t lose the ability to care for patients... Fears were unfounded."
You should get help. But you can't be sure you will be allowed to practice medicine. The medical board will decide on an individual basis. For reference, texas medical board form for mental illness and self referral program: http://www.tmb.state.tx.us/dl/C5EAB589-0916-C88D-FF94-DE8D96...
Of course, if you don't self report, and practice anyway, and a patient complains, you might be facing criminal charges.
First do no harm. Help yourself before you help others (seek mental help if you need it).
Re: Medical school can be brutal, and it’s making many of us suicidal
#126Earlier quoted context omitted.
I don't disagree with medicine being hard. I'm not going to get into the difference difficulty between learning medicine or computer science. I guess I should have mentioned my point first, which is that just like you don't need a star computer scientist to write an app for a restaurant, you don't need a doctor with all that training and theoretical knowledge to diagnose a sprained ankle. I'm sorry about your conditi…
Regarding the rarety of my condition, it's diabetes treated with insulin, so not rare by any stretch of the imagination. With a positive diagnosis and in a fairly uncomplicated case, it's a huge burden on me to learn just the single condition. Now imagine doctors who don't have to deal with only a single, well-diagnosed condition. You say that a "sprained ankle" is easy to diagnose -- but is it really? On the differe…
> You say that a "sprained ankle" is easy to diagnose -- but is it really? On the differential, how many other conditions manifest similarly? What complications can a trained doctor see, what questions do they know to ask?
We're talking probabilities here. Most likely your illness is due to the most probable cause. And if it isn't, well, stuff happens.
From wikipedia: In economics and in public-choice theory, rent-seeking involves seeking to increase one's share of existing wealth without creating new wealth.
I believe that's what a lot of doctors do these days. After a weekend of tromping through the woods, I got a case of poison oak. I had to see a doctor and get a prescription for a steroid, because apparently it's a scheduled medication.
There is a lot of overlap between a cartel and rent-seeking though.
> In my interaction with the medical industry, in no case would I have been as well-served by a "lesser expert."
Is that only from your diabetic condition, or other issues? I think the question I'm raising is that maybe sometimes "it'll do" is just as good "he's elite, I'm lucky to have him".
> I assume you still want the lesser experts we're discussing to be regulated legally, etc
No. I think you should be able to hang out your shingle without government regulation.
Re: Medical school can be brutal, and it’s making many of us suicidal
#127Earlier quoted context omitted.
I'm not sure that capitalism as such has much to do with the problem you describe, as anyone who ever went to a Soviet emergency room will be happy to tell you.
The Soviet healthcare system suffered from underinvestment due to their command economy's focus on heavy industry and military production. The problem in the United States is the exact opposite: unproductive overinvestment due to the proliferation of waste, fraud, rent-seekers, and all other types of interests that rake a profit off the top without contributing anything to patient care. It seems like a false argument…
The US health care system has not been a free market for 50 years, likely much longer. It's got very heavy government involvement at all levels.
Re: Medical school can be brutal, and it’s making many of us suicidal
#128Earlier quoted context omitted.
In these incidents, how many times did you have to reach on your advanced medical training instead of the basic ones to treat burn wounds and fix food poisoning? How was any aspect of your job improved by your years of medical school, your years of residency? Would you rather have more less trained doctors, or fewer elite doctors in those circumstances?
Its difficult to explain to lay people (and I in all honesty do not mean to be condescending) but even in the "simplest" of cases a doctor is called upon to draw on advanced skills and concepts he may not even remember he has. People fail out of the profession at various levels. A classmate of mine fled in the second year during her first dissection of a cadavar, never to return, some make it to residncy then quit. C…
> but even in the "simplest" of cases a doctor is called upon to draw on advanced skills and concepts he may not even remember he has.
But how often does that occur? And is it worth the economic cost of not having doctors available, or doctors overworked? Individual human life is cheap.
>A doctor is either capable or he/she is not. We simply cant train them halfway. There are countries that have carried out the experiment you propose and attempt to train doctors to 'adequate' levels.
Do you have a source? I'd be quite interested in reading it. And the phrase "either is capable or either he/she is not" can be applied to any other profession.
Re: Medical school can be brutal, and it’s making many of us suicidal
#129Earlier quoted context omitted.
In these incidents, how many times did you have to reach on your advanced medical training instead of the basic ones to treat burn wounds and fix food poisoning? How was any aspect of your job improved by your years of medical school, your years of residency? Would you rather have more less trained doctors, or fewer elite doctors in those circumstances?
Would you prefer to go to a medical office with your kid presenting a serious condition and get a paramedic who doesn't know what to do outside of his protocols?
I'd prefer to go to a medical office without taking out a loan. If the choice is mortaging my house to get an elite doctor to check something out or paying a reasonable fee for somebody who would probably do just as good a job, or escalate it if he was over his head, I'm going for the second every time.
Re: Medical school can be brutal, and it’s making many of us suicidal
#130My sister is currently finishing medical school at Penn. We talked about suicides in hospital and university settings.
She had an interesting perspective on the problem. She said that it isn't the intensity of the work, the academic rigor, or even the emotional damage from constant exposure to death and disease.
It's the sleep deprivation.
There is a very large amount of evidence that one night of reduced sleep massively increases medical errors. Despite this knowledge, sleep deprivation remains this massochistic macho hazing ritual, which increases in severity through residency.
It's dangerous and unnecessary.
This article does a good job of capturing the chain of internal events that lead from exhaustion to burnout to severe depression and finally to suicidal ideation.