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Medical school can be brutal, and it’s making many of us suicidal

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Re: Medical school can be brutal, and it’s making many of us suicidal

#161

Post by Spooky23 »

jimmywanger wrote: post #129
Spooky23 wrote: post #109

Earlier quoted context omitted.

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.

They have that now.

Go to your local urgent care or CVS doc in a box and you'll get a nurse practitioner who can help you out with routine stuff for low cost.

Re: Medical school can be brutal, and it’s making many of us suicidal

#162

Post by mixmastamyk »

stephencanon wrote: post #160
TheGreatPotatoe wrote: post #156

Earlier quoted context omitted.

The patient hand-off problem is real. I just feel like there is a better solution than having these folks work 80+ hours a week.

You can hire twice as many residents and make residency twice as long so they get the same total training at 40 hours a week. You'll have to significantly increase resident salaries, and allow residents to move between hospitals to deal with life events. This isn't impossible, but it's politically infeasable while everyone is talking about cutting medical costs (total pay to residents would need to go up ~10-fold for…

They won't have to train twice as long, because a great portion of those long days are wasted due to fatigue. All these reasons are excuses for sweatshop conditions that wouldn't be tolerated elsewhere.

Re: Medical school can be brutal, and it’s making many of us suicidal

#163

Post by stephencanon »

mixmastamyk wrote: post #162
stephencanon wrote: post #160

Earlier quoted context omitted.

You can hire twice as many residents and make residency twice as long so they get the same total training at 40 hours a week. You'll have to significantly increase resident salaries, and allow residents to move between hospitals to deal with life events. This isn't impossible, but it's politically infeasable while everyone is talking about cutting medical costs (total pay to residents would need to go up ~10-fold for…

They won't have to train twice as long, because a great portion of those long days are wasted due to fatigue. All these reasons are excuses for sweatshop conditions that wouldn't be tolerated elsewhere.

Have you gone through residency training? While we both consider the conditions inhumane, my wife is absolutely clear on the fact that even at the end of a shift she's still learning a ton. Surgical residents commonly stay beyond their shifts to scrub in and assist or observe especially interesting cases. Based on my conversations with my wife and other residents, you would absolutely need to extend residency to get the same training with fewer hours.

Re: Medical school can be brutal, and it’s making many of us suicidal

#164

Post by rifung »

wyager wrote: post #123
rifung wrote: post #108

Earlier quoted context omitted.

> 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 co…

> 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".

Hey I appreciate the alternative perspective.

However, at least from what you just said, I'm not convinced you do see both sides. Or maybe there's a third side..?

I actually personally do not care whatsoever about the cost of reproduction. If anything I would be happy if we reproduced less. Still, I support not being able to discriminate against women because doing otherwise supports gender inequality. It's unethical to punish a person just because they are female.

Re: Medical school can be brutal, and it’s making many of us suicidal

#165

Post by JBlue42 »

northern_lights wrote: post #91
sp332 wrote: post #70

Earlier quoted context omitted.

Isn't that a little backwards though? The more surgeons there are, the more the work could be spread out, and the hours would be saner.

1.) It's a very time-consuming and hands-on process to train a surgeon. There aren't many other fields that I'm aware of with the same level of intense apprenticeship as surgery (and medicine in general). My first thought after entering medicine was to marvel at how much effort goes into training a single physician. There is a lot of training at between a 1:1 - 1:3 student-preceptor ratio in an effort to produce very…

Q's re:

#2 - If Congress were convinced of that, would that help lower medical costs for patients or possibly increase it? That's assuming without some sort of tax increase to pay for it.

#3 - I guess this why I've heard that dermatology is one of the most competitive fields to get into - good hours, not as much stress, and good pay.

Re: Medical school can be brutal, and it’s making many of us suicidal

#166

Post by JBlue42 »

viraptor wrote: post #78
WhitneyLand wrote: post #72

Earlier quoted context omitted.

Why do you have to work 90 hours a week? Why wouldn't your employer just offer a position with less hours for less money? In software the long hours have specific reasons. For example we can't double throughput by doubling resources, and in startups the money is limited, etc

> In software the long hours have specific reasons. Yes. Bad management and artificial marketing deadlines. You can't double the throughput in some cases by doubling the resources. (in some you can) But you don't have to work in the kind of environment that expects it. I got pulled into the environment that expected long hours once. Then the manager got replaced - throughput stayed the same, people started leaving on…

I work with architects (building not software) that pull similarly long hours (and not great salaries) and when I point out that it sounds like a mix of poor planning, a poor deal with the client, or project management / process issues it's always shot down as being a 'part of their culture' that they've gone through since university.

My counterargument is that 'culture' isn't fixed and there's no reason not to strive for better and give people a chance to have lives outside work.

Re: Medical school can be brutal, and it’s making many of us suicidal

#167

Post by wyager »

rifung wrote: post #164
wyager wrote: post #123

Earlier quoted context omitted.

> 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 co…

> 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". Hey I appreciate the alternative perspective. However, at least from what you just said, I'm not convinced you do see both sides. Or maybe there's a third side..? I actually personally do not care whatsoever about the c…

You're not punishing them just because they're female; you are rationally incorporating the increased risk of them being indisposed due to pregnancy into your calculations. It's the same as car insurance companies charging more for insuring young men than for insuring young women. Whatever nice ideals we have about gender equality, there are often practical statistical differences between genders, and it's OK to recognize and use that information.

Whenever you prevent people from rationally using this kind of information in economic decisions, you are hurting more than you are helping. In the car insurance case, if insurance companies were unable to charge more for the more risky young men, this would mean that young women were unfairly subsidizing the risk of young men. So there's no net gain, and there's a bit of a cost associated with the fact that the market is no longer able to accurately transmit price information, which would have done useful things like encouraging the development of safer car technology, encourage statistically risky driver demographics to bike or take public transport rather than drive, etc.

Re: Medical school can be brutal, and it’s making many of us suicidal

#168

Post by rifung »

wyager wrote: post #167
rifung wrote: post #164

Earlier quoted context omitted.

> 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". Hey I appreciate the alternative perspective. However, at least from what you just said, I'm not convinced you do see both sides. Or maybe there's a third side..? I actually personally do not care whatsoever about the c…

You're not punishing them just because they're female; you are rationally incorporating the increased risk of them being indisposed due to pregnancy into your calculations. It's the same as car insurance companies charging more for insuring young men than for insuring young women. Whatever nice ideals we have about gender equality, there are often practical statistical differences between genders, and it's OK to reco…

> You're not punishing them just because they're female; you are rationally incorporating the increased risk of them being indisposed due to pregnancy into your calculations.

Perhaps the latter is the intention but as far as I can tell it does not prevent the former from happening.

> Whatever nice ideals we have about gender equality, there are often practical statistical differences between genders, and it's OK to recognize and use that information.

I suppose this is our fundamental disagreement then.

I recognize that there may be additional costs or burdens to businesses and even other consumers if companies are forced to ignore statistically relevant details in the name of equality. However, this is a price I am willing to pay to live in what I consider a civilized society.

In a way this thinking even prevents social mobility. After all, if you are poor, it's less likely you would have a good education or upbringing, so is it okay for companies to discriminate against the poor? Feel free to accuse me of being an idealist, but I would rather we strive to live in a society where people are judged for who they are and not their race, sex, or other things which are completely out of their control.

Re: Medical school can be brutal, and it’s making many of us suicidal

#169

Post by Alkomb »

M_Grey wrote: post #99
chriskanan wrote: post #16

My 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…

And that... is why I politely, yet firmly instruct anyone rendering medical care to not let a resident within 10 feet of me. "This is a teaching hospital!" doesn't cut it when the means of teaching are so irresponsible.

What if someone asks for directions to the nearest hospital? "We ask them politely, yet firmly to (ask someone else)."

Re: Medical school can be brutal, and it’s making many of us suicidal

#170

Post by deelowe »

pjlegato wrote: post #92
deelowe wrote: post #84

Earlier quoted context omitted.

As a father whose young son had a compound fracture recently and had to wait in the ER for 3 hours to get it patched up by a grumpy, rushed, and tired ortho, this is horrifying. Something really needs to be done about current crony capitalistic US medical industry.

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.

I said crony capitalism. I'm a free market libertarian and would totally support such a solution. Today, I had no choice in which ortho saw my son, I had no ability to discuss pricing, my insurance is limited to just the one my company provides and on and on...
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