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Letter to an Aspiring Doctor

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31–40 of 48 posts

Re: Letter to an Aspiring Doctor

#31
post #22

Earlier quoted context omitted.

Pharmacists aren't middlemen. They are licensed healthcare providers with a critical role in patient care that goes beyond just handing over pill bottles.

That may describe the professionals training and intended role in the ecosystem, but it does not describe most patients' experience of the pharmacist.

What empirical studies do you know justify this claim?

Re: Letter to an Aspiring Doctor

#32

I'm surprised there was no mention about insurance and billing requirements, etc.

Yeah, that surprised me, too. At one time in my life, I considered becoming a doctor, and had even started to take some of the required undergraduate coursework required to apply to medical school (organic chemistry, biology, etc.) I started to talk to doctors about my choice, and nearly all of them advised me not to go into medicine and often went into a long rant about dealing with insurance companies, billing issu…

Same here. My father is a veterinarian, and we have many family friends who are doctors, and they all drove me away from going into medical practice. It is a tragic waste, because my brain is not compatible with many jobs, but medicine as practiced from the 90s back would have been up my bailiwick, as it gave my father, who shares most of my neuroatypical quirks, tremendous upward mobility.

But we are men of ethical scruples. I've dropped out of multiple grad programs due to witnessing academic fraud committed by students and professors working in tandem to keep money flowing into administrators who believe it is their utmost responsibility to perform a Nietzschean transvaluation of all values until a hauntingly extreme vices become considered virtues.

If I picked the medical profession, it would be because it would be so motivating to me to work in a highly motivating high-stakes environment where finding the moral thing to do is not so everloving exhausting.

Then have a statist regime begin to intimidate and relentlessly attempt to suborn you into destroying the voice of your conscience and the essential goodness of the caring profession is utterly lost.

After leaving a university just a few credits shy of a degree due to learning that university administrators have knowingly destroyed the value of their degree by handing out 50% of their CS degrees to people the professors consider completely incompetent, I was not tempted in the slightest when the university attempted to bribe me with a full scholarship for their Ph.D. program and a guaranteed tenure track teaching job.

Why the hell would I want to perpetuate the scam of a completely decadent educational husk? I am terrified that misuse and/or ignorant design of the internet is threatening our social health; it is destroying the quality of people's education in return for monetary "profit". EDUCATION IS PROFIT IN ITSELF, money is merely potential energy that may help or hinder us toward enlightenment.

So this is why our "education" system is actually a "maleducation" system: universities as founded were dedicated to making the best possible people, but they are now committed to making the most possible profit.

Re: Letter to an Aspiring Doctor

#33
post #18

Having been privy to the coarse reality of about 20 students who survived 5 years of medical school, followed by FY1, FY2, and junior positions in the NHS, the intellectualized "best effort" mulling-over in the article couldn't be further away from reality.

As a student doctor not quite yet exposed to the true harshness of reality I feel that this article does give some perspective into the issues that I have grappled with so far in my training. The frustrations, the conundrums, the uncertainty, the humanity.

Re: Letter to an Aspiring Doctor

#34

Earlier quoted context omitted.

Yeah, that surprised me, too. At one time in my life, I considered becoming a doctor, and had even started to take some of the required undergraduate coursework required to apply to medical school (organic chemistry, biology, etc.) I started to talk to doctors about my choice, and nearly all of them advised me not to go into medicine and often went into a long rant about dealing with insurance companies, billing issu…

Same here. My father is a veterinarian, and we have many family friends who are doctors, and they all drove me away from going into medical practice. It is a tragic waste, because my brain is not compatible with many jobs, but medicine as practiced from the 90s back would have been up my bailiwick, as it gave my father, who shares most of my neuroatypical quirks, tremendous upward mobility. But we are men of ethical…

I’m sorry I don’t have much to add to the discussion but just wanted to mention that this is one of the most beautiful and insightful comments I’ve read in a while, thank you.

A book I’ve read some time ago - “Reinventing organizations” gave me back a little bit of hope for humanity, and they did detail an alternative school in germany that had all the real things a school should have - above all a passion for making its students the best, most honesf and awesome people it can.

Anyway just wnated to mention that places like this still exist, so they are possible.

Re: Letter to an Aspiring Doctor

#36

I'm surprised there was no mention about insurance and billing requirements, etc.

Yeah, that surprised me, too. At one time in my life, I considered becoming a doctor, and had even started to take some of the required undergraduate coursework required to apply to medical school (organic chemistry, biology, etc.) I started to talk to doctors about my choice, and nearly all of them advised me not to go into medicine and often went into a long rant about dealing with insurance companies, billing issu…

Our doctor who delivered our second child some 13 years ago told us he had to deliver (if I recall) 3 babies a week minimum to pay for medical malpractice insurance and he had never payed out on a malpractice lawsuit. The insurance is crazy.

Re: Letter to an Aspiring Doctor

#37

Earlier quoted context omitted.

Yeah, that surprised me, too. At one time in my life, I considered becoming a doctor, and had even started to take some of the required undergraduate coursework required to apply to medical school (organic chemistry, biology, etc.) I started to talk to doctors about my choice, and nearly all of them advised me not to go into medicine and often went into a long rant about dealing with insurance companies, billing issu…

Our doctor who delivered our second child some 13 years ago told us he had to deliver (if I recall) 3 babies a week minimum to pay for medical malpractice insurance and he had never payed out on a malpractice lawsuit. The insurance is crazy.

That is because for an obstetrician the consequences of medical malpractice are profound and expensive. They are basically either killing a child or crippling that child for the entirety of their life. If the child survives their malpractice then that child will have a life that is much shorter, or much more unpleasant, than it needed to be if the obstetrician did their job correctly and the insurance company will be paying out big money to support that child for the entirety of that child's life.

Re: Letter to an Aspiring Doctor

#38
post #8

Earlier quoted context omitted.

This jumped out at me. "Abortion was originally intended to be performed in limited circumstances only, but now has become an inalienable right in any circumstances whatever—into which, indeed, it is impermissible to inquire." followed coyly a paragraph later by "This, of course, would have the corollary that mass murder by doctors would in theory be permissible, or even obligatory."

I do not believe the author was trying to be coy, but you are eliding the paragraph which gives the correct context to the latter statement: > Moreover, though we pay lip service as a society to diversity and tolerance, we increasingly demand uniformity. A recent article in the New England Journal of Medicine argued that doctors should not be permitted to opt out of performing procedures that they considered unethica…

The actual debate among physicians is about the ethics of denying patients care to which they have a right. There is no law or legal fiat that forces physicians to do things they object to. We are instead held up to a standard of care by our professional regulatory bodies, which define how a physician should act in order to be considered a member of the profession. Most of the rules are around ethical behaviour. With regards to conscientious objection, our professional bodies attempt to balance a patient's right to access timely, effective, and legal treatment against the physicians right to practice their personal ethics. How most bodies reach that balance is to say that physicians are required to provide timely referral to another provider for any service that they are morally objected to. For example, if you don't believe that abortion is right, you are not required to provide them (not by the regulating body and definitely not by the law), but you also can't prevent your patients from getting abortions--you need to refer them to someone who can. We can't force our personal ethics on our patients. The linked article appears to be arguing that doctors should be able to just say no, and thereby prevent someone from accessing the care that they want.

Ultimately, the patient is the most important person in medicine, the doctor comes second. This is not the law, this is medical ethics.

Re: Letter to an Aspiring Doctor

#39

Earlier quoted context omitted.

Yeah, that surprised me, too. At one time in my life, I considered becoming a doctor, and had even started to take some of the required undergraduate coursework required to apply to medical school (organic chemistry, biology, etc.) I started to talk to doctors about my choice, and nearly all of them advised me not to go into medicine and often went into a long rant about dealing with insurance companies, billing issu…

Same here. My father is a veterinarian, and we have many family friends who are doctors, and they all drove me away from going into medical practice. It is a tragic waste, because my brain is not compatible with many jobs, but medicine as practiced from the 90s back would have been up my bailiwick, as it gave my father, who shares most of my neuroatypical quirks, tremendous upward mobility. But we are men of ethical…

Why not give us a list of universities and involved persons? The only reason they do it is because they don't think fraud will devalue their reputation, and if nobody finds out about it, it won't.

Re: Letter to an Aspiring Doctor

#40
> You will no doubt hear a great deal about patient autonomy, the principle that the patient must be allowed to choose treatment that he wants.

This must really be tough on doctors. I have a few people in my life who love seeking out medical advice but rarely follow it.

"You have to help me doc, I'll do anything!"

"Ok, do X"

"Well anything but that."

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