Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

The darker side of being a doctor (2017)

drericlevi.substack.com

Post reply on HN
Print view View original

261–270 of 521 posts

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

#261

Post by galahad_ »

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…

Because you can't just set a higher number of students per year, for more students you have to create more facilities first. It's not like IT, where you can learn everything pretty well basically just with a study program, books and online lectures. As a medical student you have to do a lot of practical stuff with things that you don't get at home.

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

#262

Post by tejohnso »

ndjshe3838 wrote: post #202
tejohnso wrote: post #192

> I had worked in a hospital where I was oncall 24/7, 12 days out of 14. I had fortnightly weekends off. Why would you do this? Some of the most basic labour jobs have better employment terms than this. > You might ask, why can’t you work less? It’s not as easy as that. If I decide to work less, who is going to cover the hospital? Yes, I did ask. But covering the hospital isn't your problem, that's a hospital managem…

Because they actually care about the patients and the work is critical? You can’t just job hop like in tech? It’s like everyone on this site views the whole world through a super narrow “tech worker” lense and assume every job works the same and everyone has the same motivations as people in tech

> Because they actually care about the patients and the work is critical?

That's not a good reason to be overworked to the point of extreme misery and possibly suicide.

You can care about your patients, do critical work, and still have a workload that is reasonable.

As the author said, there was one job that was much more enjoyable. I'm sure they cared about the patients in that job just as much as they cared about the patients in the miserable job.

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

#263

Post by beryilma »

I have no sympathy for doctors. They are a part of an exploitative system, and they know and accept it. Most of them are in it for money, in the first place.

The experience that the author describes is not much different than a fancy lawyer's or that of a Wall Street finance person. They all knew about the long hours, but money is more attractive...

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

#264

Post by Solvency »

toldyouso2022 wrote: post #251
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…

It's the same in the US, Italy, etc Doctors are a cartel receiving a monopoly from the State. That's all there is to it, really

but.. why?

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

#265

Post by bitzun »

ejstronge wrote: post #169
paxys wrote: post #73

Earlier quoted context omitted.

Because doctors' associations and regulatory bodies (like AAMC in the US) lobby to keep it that way to keep the value of their profession up.

> Because doctors' associations and regulatory bodies (like AAMC in the US) lobby to keep it that way to keep the value of their profession up. This isn't true of the AAMC position in the US today, and when it was true in the 90s, there were many articles about an upcoming oversupply of physicians. First, US medical school graduating classes are smaller in number than the number of available residency positions. So e…

Not to disagree with any of your points, I'm skeptical of the proportion of NPs that can safely practice any medicine at all. I've met one competent PA, one PA who didn't understand basic human anatomy, and an PMHNP with a PhD who had seemingly no knowledge of pharmacology at all. Then I stumbled across some forums about 'noctors' with horror stories about real doctors taking patients suffering from malpractice by NPs.

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

#266

Post by smallmancontrov »

galahad_ wrote: post #261
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…

Because you can't just set a higher number of students per year, for more students you have to create more facilities first. It's not like IT, where you can learn everything pretty well basically just with a study program, books and online lectures. As a medical student you have to do a lot of practical stuff with things that you don't get at home.

Facilities can be built. Training programs can be expanded. Those are reasons why programs can't be doubled this year, but inside of a few years it's all possible. This problem has been cooking for decades.

What actually happened was cartel shit.

https://www.washingtonpost.com/archive/politics/1997/03/09/r...

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

#267

Post by fasa99 »

smallmancontrov wrote: post #266
galahad_ wrote: post #261

Earlier quoted context omitted.

Because you can't just set a higher number of students per year, for more students you have to create more facilities first. It's not like IT, where you can learn everything pretty well basically just with a study program, books and online lectures. As a medical student you have to do a lot of practical stuff with things that you don't get at home.

Facilities can be built. Training programs can be expanded. Those are reasons why programs can't be doubled this year, but inside of a few years it's all possible. This problem has been cooking for decades. What actually happened was cartel shit. https://www.washingtonpost.com/archive/politics/1997/03/09/r...

I agree with this - in the US we have nurses picking up doctor roles (e.g. anesthesia), hours-worked caps, PAs (physician assistants) also picking up doctor roles, tons of international physicians coming for underserved specialities (family medicine, pediatrics, psych, etc).

And of course, residents super overworked. I think it speaks for itself that making medicine 2x - 3x more people per year would help the problem. Yes, there's a "sweet spot" where quality of doctors would drop, but there's also a sweet spot where services rendered drop due to overwork, and we're on the far side of that one

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

#268

Post by ketzo »

Solvency wrote: post #264
toldyouso2022 wrote: post #251

Earlier quoted context omitted.

It's the same in the US, Italy, etc Doctors are a cartel receiving a monopoly from the State. That's all there is to it, really

but.. why?

It’s extremely beneficial to the people who are already doctors (dramatically increases salary, prestige, power), and that is a powerful group in most societies.

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

#269

Post by skybrian »

maCDzP wrote: post #56

My not so generous and extreme take is that the medical profession has a “hero culture”. There is prestige in working your ass of and living for work. Work life balance is for the weak people who can’t take it, they are not real health professionals. They don’t have what it takes. I have seen the same culture in aid work. I find it ironic that both health professionals and aid workers are there to help people, but no…

Health care professionals do form unions and go on strike sometimes, which can be seen as a way of looking out for each other.

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

#270

Post by PaywallBuster »

galahad_ wrote: post #261
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…

Because you can't just set a higher number of students per year, for more students you have to create more facilities first. It's not like IT, where you can learn everything pretty well basically just with a study program, books and online lectures. As a medical student you have to do a lot of practical stuff with things that you don't get at home.

it's a monopoly end of story

in portugal, public workers are one of the biggest lobbies

medicine

- can't be taught at (non public) private universities

- there's limited growth in class sizes/etc

- it's nearly impossible to get into due to grade inflation at high school, which means only the richer paying for private high school pass it (requires grade 19.x/20 at least)

At the same time, there's 100s of nursing schools (can't be too different can it?), there's way too many nurses and way too few doctors.

We're importing doctors from cuba and other countries to fill the gap.

Some people decide to study abroad (within EU) because yay, you study medicine in eastern europe, you may come back to work in Portugal because EU, and again only the richer people could afford this

Post reply on HN