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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)

#351

Post by tasuki »

wuj wrote: post #132

One point I resonated with is the high administrative overhead of being a doctor. I can imagine the stress of using an outdated EMR system when the time you have for each patient is so limited. I see lots of AI companies are trying to transform the MedTech industry, but I'm unsure how much of their products useful / are actually adopted by the hospitals. Maybe some experts in that space can enlighten me on that? I al…

> the stress of using an outdated EMR system

Using an outdated EMR system is hardly a cause of stress. A more usual cause of stress is being forced to use a brand new (and unusable) EMR.

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

#352

Post by alfiedotwtf »

bravura wrote: post #350
alfiedotwtf wrote: post #335

Earlier quoted context omitted.

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.

I mentioned garden gnomes as an example of how supply side economics and “scarcity drives demand” doesn’t work.

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

#353

Post by jjackson5324 »

viraptor wrote: post #326
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.

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.

I don’t know about other countries but that’s absolutely the case for the US.

The culprit is the AMA.

> In the 20th century, the AMA has frequently lobbied to restrict the supply of physicians, contributing to a doctor shortage in the United States.[10][11][12] The organization has also lobbied against allowing physician assistants and other health care providers to perform basic forms of health care. The organization has historically lobbied against various of government-run health insurance.

https://en.wikipedia.org/wiki/American_Medical_Association

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

#354

Post by dan-robertson »

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.

This makes sense in the IS, and the AMA does indeed try to limit the number of graduating medical students. But in the UK most doctors will work for the state where they are all on the same pay scale (I think) so a lack of supply shouldn’t be expected to push up the price of labour much.

One reason you could imagine is that the health trusts determine roughly how many student doctors they are able to train and then the government limits graduation rates based on this. But I don’t know if that’s the actual reason, and it could be a half-reason, eg the number was set a long time ago and not updated.

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

#355

Post by GuB-42 »

mcmoor wrote: post #254
GuB-42 wrote: post #219

Earlier quoted context omitted.

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…

I don't know, lower skilled doctors can be quite a pseudo science amplifier at worst. Sometimes it does feel like that no doctor is better lower skilled one, especially when self treatment (or more accurately, remote treatment) is getting better nowadays.

The problem is worse when there is a lack of actual doctors.

It people can't see a doctor, or can't get decent care because doctors are overworked, they will go to the "pseudo doctors". "pseudo doctors" are usually much less regulated, because they don't really practice medicine, can't make prescriptions, are not covered by healthcare subsidies, etc... but they are available, and actually caring, because there is no shortage of them.

This is actually good for the patients, sometimes, all you need to get better is someone who listens to you and points you to a healthier lifestyle something, something that "pseudo doctors" can do well. The problem is when they bring their pseudoscience to "treat" actual medical problems that can't just be solved by eating vegetables and getting some rest.

Now imagine an actual doctor who is available and caring, giving you all the benefits of the "pseudo doctor", but in addition, can actually practice medicine. Maybe not to the highest level, but he would have attended an actual medical school and knows enough not to treat cancer with fruits.

The problem now in many places is that it is not just hard to become a doctor, it is hard to access medical studies.

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

#357

Post by samus »

to1y wrote: post #282
CydeWeys wrote: post #197

Earlier quoted context omitted.

I have. Longer shifts with fewer turn-overs results in better patient outcomes.

That's strange as you would expect quality to suffer in every single respect when forced to work inhumane conditions. I would find a different mechanic if I thought the one I was considering was miserable from being overworked. Was there an explanation for why outcomes improved? Perhaps it is necessary to look into who conducts these studies as I imagine someone up the ladder profits greatly from having 1 doctor do t…

One simple reason might be this over: people make errors over time, but they become familiar with the case. That familiarity is lost whenever they hand over a patient. And you can't solve that with documentation since people would be busy all day doing paperwork instead of caring for patients.

This problem exist in every domain, and in medicine it can have deadly consequences. People sign up to become doctors knowing that they will have to work crazy shifts. But I guess they underestimate how the system hobbles them since it is focused on being efficient, not on achieving the best outcome for the patients.

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

#358

Post by pipes »

dan-robertson wrote: post #354
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.

This makes sense in the IS, and the AMA does indeed try to limit the number of graduating medical students. But in the UK most doctors will work for the state where they are all on the same pay scale (I think) so a lack of supply shouldn’t be expected to push up the price of labour much. One reason you could imagine is that the health trusts determine roughly how many student doctors they are able to train and then t…

And training doctors is very expensive. This is subsidised by the state through capped tuition fees. Plus to train a doctor you need enough doctors for junior doctors to train the junior doctors presumably.

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

#359

Post by sanbor »

Just wanted to share that Cuba is the country with most "doctors per 10k people" with a ratio of 84.2 doctors. In comparison, USA has 26.1 and Australia 41. I just find it very interesting that Cuba has 300% more doctors than USA.

[1] Sorting by Latest available data (2020–2023 https://en.wikipedia.org/wiki/List_of_countries_and_dependen...

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