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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)

#341

Post by switch007 »

robocat wrote: post #133
switch007 wrote: post #120

Earlier quoted context omitted.

In the UK they severely limit access to any diagnostics, and your GP just gives you antibiotics and/or anti depressants. At the hospital, they just classify your symptoms as “not critical”, refuse to admit you and kick you back to your GP, who then refuses to refer you for any investigations, I imagine because there is a gun to their head over targets etc If your levels are high, you’re told oh it’s not severe. If it…

That reduces access but it doesn't affect the demand for healthcare. I'm in New Zealand: not a heap better than you describe. Here GPs are overworked and getting an appointment is difficult. The health system has waitlists to control access to a limited number of procedures performed in each specialty. You need to be healthy enough to pass the access requirements and for acute surgery you need to live long enough to…

Depends how you define demand. People who need and seek care, or just those who need care?

Some people absolutely don't bother seeking care because they know they'll be denied care without a huge battle

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

#342

Post by earlone »

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.

Absolutely not. Not all IT jobs & Doctor jobs are created equal. Entry-level roles might not warrant super high salaries in either case. Both IT and Doctor fields have a spectrum of jobs with varying pay scales depending on complexity and criticality.

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

#343

Post by jampekka »

p1dda wrote: post #283

I am a working physician (50+) that is currently in training to become an IT professional, preferably working with development of new patient records systems. Being a physician is just not very intellectually challenging, more emotionally challenging, programming is in my mind a real challenge. Any others with experience of changing fields?

> preferably working with development of new patient records systems.

That field is quite a mess. There's a oligopoly of few large vendors with low quality products but high quality politics and sales. Although as a working physicians you're probably familiar at least with the results.

Edit: Further discussion, including EHR system developers, here: https://news.ycombinator.com/item?id=39186252

Having been on the user side could be a major upside for improving the efficiency of the systems, but I'm afraid the business model of EHRs don't really allow for improving the systems much.

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

#344

Post by throwaway2037 »

GuB-42 wrote: post #219
lilsoso wrote: post #146

Earlier quoted context omitted.

We should enforce rigorous qualifications for doctors. We've relaxed the standards far too much already.

Sure, but no doctors is worse than lower skilled doctors as even lower skilled doctors are better than the average patient self-treatment attempt. We need doctors who are available to treat simple conditions and refer to a more qualified doctor for the complex ones. Such a job doesn't require being a genius, just people who are not complete idiots, and the qualifications required here are genius-level, not idiotproof…

    > We need doctors who are available to treat simple conditions and refer to a more qualified doctor for the complex ones.
This is most medical systems work in highly industrialised nations. First, you visit a GP. If necessary the send you to a specialist.

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

#345

Post by throwaway2037 »

amluto wrote: post #198
lilsoso wrote: post #146

Earlier quoted context omitted.

We should enforce rigorous qualifications for doctors. We've relaxed the standards far too much already.

I suspect that, after some point, making the qualifications stricter actually drives away many of the best candidates.

I doubt it. They pay is high enough to attract more people than necessary. Most ultra high income jobs are the same.

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

#346

Post by adaml_623 »

anovikov wrote: post #338
ketzo wrote: post #268

Earlier quoted context omitted.

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.

In the U.S., sure. But in the UK status of a doctor is akin to that of a schoolteacher. Totally not a highly sought-after, profitable career like it is in the U.S.

Doctors are paid a lot more than schoolteachers in the UK and in my experience are respected because of their profession. I think you're totally incorrect.

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

#348

Post by lazyasciiart »

mlyle wrote: post #227
lll-o-lll wrote: post #217

Earlier quoted context omitted.

This is just wrong. The supply is absolutely artificially capped, particularly for positions like surgeons. This is controlled by the Royal Australasian College of Surgeons in combination with government funding. There is no “private, full-fee universities that are not so limited” alternate path; don’t make stuff up. Source: Brother in law who is a surgeon.

> This is just wrong. The supply is absolutely artificially capped, particularly for positions like surgeons. I feel like you don't understand the distinction about positions at universities for initial medical training vs. internship and residencies, which I believe I discussed fairly above. see > > Internship slots, in turn, are set by disparate government agencies. They've climbed, but probably not climbed enough.…

To start with, you’re overestimating the role of full fee paying university places, Australia doesn’t have provinces, and the intern year is not equivalent to an American internship - that’s the registrars, and there are fewer of those than internships. (This is the position you need to get in order to begin any specialty training, such as surgery. They are very explicitly managed and funded by the federal government. https://www.anao.gov.au/work/performance-audit/administratio...)

More generally, Australia does have states and territories, but the federation model is far more centralized than the US: for instance, public hospital funding is a shared pool coordinated by federal agreement. https://www.publichospitalfunding.gov.au/victoria-basis-nati... While the vast majority of internships are at public hospitals, the federal government also pays directly to create a relatively small number of internships at private hospitals.

But of course this is all largely irrelevant because about one third of doctors in Australia completed all of their training in another country, and were then awarded a visa based largely on their profession being listed as a national priority under the system managed by the federal government.

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

#349

Post by xiwenc »

mewpmewp2 wrote: post #208
catlikesshrimp wrote: post #164

Earlier quoted context omitted.

Not everywhere though. The life of a doctor is much better in Costa Rica, even in public institutions. The extra time is paid. And the syndicates are strong (which has worked well) The doctors in Nicaragua, the neighboring country, is as described in your comment, except the economy of the whole country is in shambles, and they also have to "voluntarily" participate in "government" political activities. Oh, and since…

But Costa Rica has one of the longest wait times for non emergency surgeries. https://www.oecd-ilibrary.org/sites/f8ac5867-en/index.html?i... So high wait times there doesn't sound entirely perfect either.

Perhaps this is related to the fact:

Cost of medical treatment and holidays included still cheaper than America?

Fits perfectly for non-emergencies.

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

#350

Post by bravura »

alfiedotwtf wrote: post #335
sslayer wrote: post #274

Earlier quoted context omitted.

Also, being a coveted occupation ensures that there will always be a pool of people fighting for it. Scarcity drives demand.

Not always. If I sell garden gnomes wearing knitted hats, but I only make three a year and sell to only people who drive yellow cars, I doubt I could earn a decent living off this

Don’t be obtuse. You’re comparing garden gnomes with healthcare.
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