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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)

#321

Post by twojobsoneboss »

lll-o-lll wrote: post #222
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…

Yes this does seem to be the culture, at least for doctors working towards the more competitive specialties (such as surgeons). Things get much less hectic once they reach “consultant” at age 35 or so, but it’s an absolute grind until then. With no guarantee of success! If you see your GP with a bunch of extra paper on the wall, chances are they are one of the many that didn’t win the game. What’s a good alternative…

“Jobs for life” part is huge and under appreciated - there aren’t many jobs where you don’t have to worry about ageism nowadays

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

#322

Post by lelanthran »

kwhitefoot wrote: post #93
317070 wrote: post #79

Earlier quoted context omitted.

What I don't understand: Say I'm a doctor, and I declare I will only work my 40 hours (or however much a full time is where you are). I will literally leave when my time is up. Oh, and I don't pick up phones outside of work. Or read emails. What will anyone else do about it? Fire me? Then they have even less doctors... It seems to me doctors do have the power to change things, even without collectivizing. But for som…

They would earn less money. > the power to change things, even without collectivizing. Not really it's a sort of prisoner's dilemma. The one who refuses to work stupid hours gets fired and someone else has their job. If they stood together then it might work.

> Not really it's a sort of prisoner's dilemma. The one who refuses to work stupid hours gets fired and someone else has their job.

Is this relevant in a profession that already doesn't have enough practitioners?

I mean, let's say there is a shortage of 100 doctors in a location that currently has 900. If you fire one, wouldn't they easily pick up one of the open 100 slots?

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

#323

Post by BrandoElFollito »

rr808 wrote: post #152
jajko wrote: post #135

Earlier quoted context omitted.

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.

Hey, there is a reason you can use Internet and this is us :)

It is not that IT is overpaid, it is that doctors are underpaid - at least in France.

We are the world champions of strikes and yet, somehow, doctors rarely go on strike. I do not know why.

They also know where they are going, it is not like they discover the world of medicine after 8 or 10 years.

I am happy that they are people who want to help others, but they also need to eat, sleep and party. Nobody will give them that if they do not protest.

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

#324

Post by BrandoElFollito »

arp242 wrote: post #151
bsdz wrote: post #134

Earlier quoted context omitted.

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 manuf…

I highly doubt that when I come with my kid who sneezes and have fever because half of his class sneezes and heads fever, the MD wold stop and think "ha, maybe he has a brain tumor or this entroprngiforitholzmosis that I heard about 37 years ago".

Not only Computer Aided Medicine would be a god send (it could help to duagnoze the entroprything above the MD forgot about, but would also help to leave the time for people actually sick with something an MD can help with

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

#325

Post by wiether »

BrandoElFollito wrote: post #323
rr808 wrote: post #152

Earlier quoted context omitted.

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.

Hey, there is a reason you can use Internet and this is us :) It is not that IT is overpaid, it is that doctors are underpaid - at least in France. We are the world champions of strikes and yet, somehow, doctors rarely go on strike. I do not know why. They also know where they are going, it is not like they discover the world of medicine after 8 or 10 years. I am happy that they are people who want to help others, bu…

If you're talking about the situation here in France, it's a bit different regarding money. Doctors are still paid more than most people in IT. Given the IT money in the US, I'm not sure they have the same situation if we look at the hourly rate.

Regarding doctors strikes, I asked the question to multiple ones and the few explanations I got are : - they are deeply regulated and organized, they rely more on acting behind the scenes (lobbying) than going public in the streets - they still have a comfortable situation that they chose ; unlike blue-collar workers who can barely afford food/housing and have to take what job and salary is offered to them ; a GP can move to a private hospital if they want more money and less hours - even though they are organized, they have much more individualistic views of their job than labor workers ; after all they mostly are their own company

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

#326

Post by viraptor »

ketzo wrote: post #268
Solvency wrote: post #264

Earlier quoted context omitted.

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.

I'm not sure that's a good enough explanation. There's minimal if any impact from a given doctor on country wide policies, especially the ones funded by state. Junior doctors in the UK couldn't push basic improvements to both their working conditions and pay. That doesn't seem to match the idea that they can meaningfully influence the doctors intake numbers.

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

#327

Post by makeitdouble »

user_7832 wrote: post #2

Most of the issues mentioned in the article and the included email are concerning, however they also oddly seem to be common in many places across the globe. The surgeon mentioned was in Australia, I have seen these issues first hand in the Netherlands and am aware of very similar of the first 2 out of 3 issues (caused by overwork/understaffing/over-fatigue etc) in Belgium, Germany, the UK, India and god knows how ma…

I've looked at all the other replies and very few mention the obvious: self-regulation is hard.

Hospitals are mostly held as public services, and having more doctors better handled arguably costs more (in training, infra, shift management etc). Gov gets to decide if it wants to pay more, or even change the status quo and bails on it.

It's the same deal for teachers in public schools and other public servants, their mental health management is lagging, their salaries and treatment as well, dispatch and promotions are a PITA etc.

I don't think govs are inherently bad at it, just that there's no check and balances most of the time. Same way private companies are bad at self regulation and need an external force to get regulated. Mandatory unionizing and better avenues to sue for better conditions could be an answer?

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

#328

Post by praptak »

gverrilla wrote: post #297
praptak wrote: post #53

"Medicine used to be a meaningful pursuit. Now it has become a tiresome industry. The joy, purpose and meaning of medicine has been codified, sterilised, protocolised, industrialised and regimented. Doctors are caught in a web of business, no longer a noble vocation. The altruism of young doctors have been replaced by the shackles of efficiency, productivity and key performance indicators." That's textbook Marxist al…

> It was not supposed to happen to middle class workers though. Don't think Marx wrote or said that. Any source?

I meant the "Marxism was about 19th century factory workers, I'm middle class so it doesn't apply to me" line of thinking.

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

#329

Post by zelphirkalt »

rr808 wrote: post #129
game_the0ry wrote: post #88

I don't understand why doctors that are entering the field need to be over-staffed and over-worked. I have a cousin who is an Er surgeon and she needs works 3 days a week, but that certainly was not the case when she was starting out. The work culture of the medical profession looks horribly inefficient. What benefit do you get from buying out young doctors?

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.

In reality it would probably be 2 people doing 13h shifts or 3 people doing 9h shifts, in order to have overlap for handovers and because of hygiene rules, that do not let you walk right in.

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

#330

Post by zelphirkalt »

Zenzero wrote: post #246
starluz wrote: post #215

Earlier quoted context omitted.

I feel like technology could very easily solve this eventually

If you find some problem that plagues millions of very smart people, and your thought is "technology could very easily solve this", the first thing you should ask yourself is what you're missing.

The problems are aversion to technology in places, unwillingness to adopt new (human) protocol/processes, entrenched proprietary technology, that does not adhere to standardized formats.

Say you want to save a report for a patient for the next shift. That report needs to enter a computer system. If there is a system for that, it will most likely be a very expensive overpriced proprietary solution with expensive support contract, instead of something that has an open and intelligent format, that could be read by simply any software. The companies behind the tools will paint themselves as "specialists" for medical technology and do everything to dig a moat, at the cost of lives and they will avoid standards, as that will make their overpriced solution replaceable.

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