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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)

#151

Post by arp242 »

bsdz wrote: post #134
arp242 wrote: post #123

Earlier quoted context omitted.

Your own link contains your answer: > Expanding the cap on medical and dental school places is complicated by the cost of training, current university and clinical placement capacity, and the current number of clinically qualified academic staff who design and deliver courses. Furthermore, the NHS actually needs the funds to hire staff. The core problem is that people are getting older with more complex health care r…

I don't really feel it does. Sure I can see the costs involved complicate things. However, doubling the cap will likely introduce some economies of scale, surely that would reduce training costs. Also capacity would grow to meet training demand; Universities are always keen for more students. Also increasing the working pool will ultimately lead to more "clinically qualified academic staff". All this might become irr…

> All this might become irrelevant with technology replacing GPs/Physicians. Perhaps in 10 years time we'll be examined by robots at our local pharmacy.

lolno. Aside from the fact that AI is nowhere near good enough, we can't really build robots anywhere close to the dexterity required to do many of the physical actions. Also people like having human contact.

"Economies of scale" only works well for things like manufacture, and is much more limited for many other things. It certainly doesn't reduce the cost of actually paying a yearly salary to these people, or ensuring you have enough places (hospitals) for the to work at, which isn't cheap either. There are some small advantages one can take here on there, but in general, it scales fairly linearly. This is not just me saying that, your own link, again, says that.

Training 10 junior devs really is about 10 times as much work as training 1. Maybe slightly less because you can group some things, but not too much. And training 20 junior devs is about twice as much work as training 10.

It really is just a funding issue – which is what everyone has been saying for years. Labour wants to increase spots by abolishing non-doms – we'll see if that works when they win the election.

Otherwise feel free to stand for election and propose the n% tax hike required for all of this and see how well that goes.

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

#152

Post by rr808 »

jajko wrote: post #135
rr808 wrote: post #125

Earlier quoted context omitted.

An associated problem is that bright people from rural or poor areas who are really passionate about being a doctor dont get the right grades to get in. Middle class kids in cities get in because its a good career but dont really like it that much and definitely dont want to work outside their city. My brother worked as a doctor until his thirties then quit, such a waste of training.

In Switzerland, at least for the french part, most of the doctors are not Swiss anymore. It literally became white collar immigrant job. Wife is one of those and sees the problem very clearly due to speaking about this with both (those few) swiss colleagues and the rest - its simply not attractive career path for locals, too much suffering and risk for relatively little reward. Those bright enough go to law, IT and s…

I think its similar worldwide. Like I said my brother quit. Its also true that IT people are ridiculously overpaid. Both problems will inevitably revert to the mean.

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

#153

Post by rr808 »

dimal wrote: post #143
rr808 wrote: post #129

Earlier quoted context omitted.

Some wards with really sick people benefit from having longer shifts as you see the person progress and have fewer shift changes. Ie with 2 people doing 12 hr shifts is better than 3 people doing 8 hours shifts as the doctors and nurses see how a patient is doing and dont have to communicate to next shift. Something like ER where people come and go all day wouldn't benefit from this however.

I’d rather have three well-rested people and an additional shift change than two burned out, exhausted people. People who are exhausted make mistakes. Maybe it would be better to focus on improving internal communication.

Maybe, I think we have to trust the medical people that they know what they're doing. My baby daughter was in incubated in ICU twice with severe Bronchiolitis. It was nice to see the same people look after her for a week rather than a continual stream of people clocking on and off.

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

#154

Post by gosub100 »

IncreasePosts wrote: post #11

I know America strictly limits the number of people who can become doctors every year. Does Australia have a similar system? It seems insane to me to first limit how many there can be, and then overwork the ones you do allow to become doctors.

Its not just limiting the numbers, but also the way matching is done. The current way is that upon admission to med school, you must be willing to accept just about any practice specialty. This is another thing that could be flipped on its head by allowing you to be any kind of doctor, provided that you attain the required MD and complete training.

Yes, I know, certain medical specialties are very competitive, but (IMO) they should be forced to admit you if you pay for the training. For instance, if I could be a radiologist, I would. But I dont want to be any other kind of doctor. They could say "ok, you will be eligible for radiology residency upon earning an MD and completing some standardized program proving you learned the book-side of radiology. Upon completion of that, (and , say 1 year of generalist MD work), then some radiology residency essentially has to admit you. Not interview for it, and jump up and down like a puppy, and based on how likeable you are, maybe, they let you in.

This could open the door for non-traditional doctors in general: Word could get around, "hey, this podiatry program is cool, 2 years training, 1 year public service, and you could earn $200k", knowing what kind of dr you will be might have an interesting effect in attracting people who otherwise would have never considered it (to fill the unpopular specialist roles like podiatry or psychiatry).

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

#155

Post by peschu »

jajko wrote: post #135
rr808 wrote: post #125

Earlier quoted context omitted.

An associated problem is that bright people from rural or poor areas who are really passionate about being a doctor dont get the right grades to get in. Middle class kids in cities get in because its a good career but dont really like it that much and definitely dont want to work outside their city. My brother worked as a doctor until his thirties then quit, such a waste of training.

In Switzerland, at least for the french part, most of the doctors are not Swiss anymore. It literally became white collar immigrant job. Wife is one of those and sees the problem very clearly due to speaking about this with both (those few) swiss colleagues and the rest - its simply not attractive career path for locals, too much suffering and risk for relatively little reward. Those bright enough go to law, IT and s…

The picture you are painting is way too dark. And does not give a realistic picture.

A lot of what you say is true for doctors in their first 5-10 years into their career, when employed in a hospital.

This not true for doctors which reached a certain level like „oberarzt“ and above.

This is especially not true for doctors with their own „office“ (business).

Yeah people may cry, but normally it is very hard to bring a doctor to justice even when there are quite obvious mistakes or misconduct. They are very well protected, suing a doctor not seldom takes 10 years from start to verdict, with a lot of legal costs involved.

And last but not least, it is a very secure profession. You must be really really stupid to end up jobless. So you have 5-10 years with a „ok“ salary compared to the power you invest. And 20-30 Years with a very good to exceptional salary, especially when compared to the broader population.

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

#156

Post by lukko »

quasse wrote: post #150
wuj wrote: post #132

One point I resonated with is the high administrative overhead of being a doctor. I can imagine the stress of using an outdated EMR system when the time you have for each patient is so limited. I see lots of AI companies are trying to transform the MedTech industry, but I'm unsure how much of their products useful / are actually adopted by the hospitals. Maybe some experts in that space can enlighten me on that? I al…

> I see lots of AI companies are trying to transform the MedTech industry, but I'm unsure how much of their products useful / are actually adopted by the hospitals. Maybe some experts in that space can enlighten me on that? My impression (as an outsider with a partner in the medical field) is that the prime function of the "medical industry" is to generate reams and reams of documentation about "care provided" to an…

There are a few other reasons - doctors document every interaction partly for medico-legal reasons – just in case something happens. The notes become especially long and defensive in any situations that have a possibility of being misinterpreted. If it's not written down, it didn't happen. It's obviously also a record for other clinicians / healthcare professionals to read through and see what happened during the admission.

But yep I do worry about any kind of generative AI in this context.

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

#159

Post by candiddevmike »

thundergolfer wrote: post #34
IncreasePosts wrote: post #11

I know America strictly limits the number of people who can become doctors every year. Does Australia have a similar system? It seems insane to me to first limit how many there can be, and then overwork the ones you do allow to become doctors.

Though significant restrictions on supply do exist, the problem does not seem to be nearly as bad in Australia as in the USA [1]. In Australia there's ~15 medical graduates per 100k vs ~8 in USA. The doctors in Australia are still definitely overworked though. A decent number of the people I went to school with became doctors in Australia, and though we work roughly the same number of hours (~60-70hrs/week), my work…

Why do you work that many hours?

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

#160

Post by Havoc »

I didn't even consider surgeon as an option. The idea of a life being dependent on my steady hand, skill and knowledge is terrifying. Literally I'm having a bad day, mess up, someone dies?

...having people brave enough to take that on drown in red tape is a shameful black mark on society.

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