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The darker side of being a doctor (2017)

drericlevi.substack.com

381–390 of 521 posts

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

#381
post #380

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

I think you’re giving way too much credit to medical associations to rig the game in their favor. They exert enough influence over all fifty states and the various private institutions to systemically deny training to qualified candidates? The fact is it’s extremely expensive and time consuming to train physicians. There isn’t enough space. Third and fourth year med students are going to far-flung hospitals to have h…

You just spend more money to scale the program. Funding for the residency program has been frozen since the late 90s, the demand for doctors has not been.

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

#382
The shocking side of becoming a doctor: https://en.wikipedia.org/wiki/This_Is_Going_to_Hurt

A medical student keeps a journal, becomes a doctor, hates his life, publishes his journal. One post I am laughing my ass off, the next I am in tears. It changed my perspective entirely and I recommend anyone read it.

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

#383
post #380

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

I think you’re giving way too much credit to medical associations to rig the game in their favor. They exert enough influence over all fifty states and the various private institutions to systemically deny training to qualified candidates? The fact is it’s extremely expensive and time consuming to train physicians. There isn’t enough space. Third and fourth year med students are going to far-flung hospitals to have h…

> They exert enough influence over all fifty states and the various private institutions to systemically deny training to qualified candidates?

Politicians "trust the experts" and the American Medical Association says...

The flaw is the AMA is just a union for doctors not a body that represents patients in any way.

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

#384
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…

In France, like in others countries, we have the same kind of problem. So much actually that we "import" medics from other countries !!!!

Lastly, the gov finally acknowledged the problem and tried to suppress the "numerus closus" (limiting the number of medecine students) but the problem is now that... there's

- not enough teachers and not enough room in universities

- not enough position in hospital for "internship" (not sure if it's the right word) because theses interns have to be managed by experienced medics

- it takes a loooooong time to make a doctor

- "young" doctors don't want to spend countless hours without personal life like previous generation did... so more doctors are needed !

And the problem is even more pregnant for out-of-hospital doctors (particularily outside of cities)

Right now, the gov strategy is to try to give more and more power for nurses, pharmacists to limit load on doctors (and cost for social services)... but sometimes doctors may spot specific symptoms where others may not

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

#385

Earlier quoted context omitted.

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 suppo…

https://xkcd.com/1831/

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

#386
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

This is definitely the case in Finland too. Somehow there's a chronic shortage of doctors, but only minimum increase in number of students, something which government could easily control through funding. Meanwhile lots of other university degrees have become less and less valuable, because too many students graduate.

Doctors's simply have the strongest association/union to preserve their privilege. No wonder why they easily earn way more than your average senior software engineer, lawyer or whatever around here. After the first few years from graduation, many of them go work in private sector where there's generally less stress, and 3-4 day workweeks are pretty common too, as they can afford it. Not a bad deal at all.

Here it has got to the point where young Finns pay money to go study in poorer countries like Latvia and Romania, because it's too hard to get in medical school here.

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

#388
i was in the waiting room for surgery, sitting in front of the vending machine. i saw surgeons come out there to get their lunch from the vending machine. i thought about how hangry i can get trying to code around lunch time. also thought it was wrong that i got an hour lunch break and they don't.

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

#389
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…

Supply management. It’s how you keep incomes artificially high.

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

#390
post #155
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…

The picture you are painting is way too dark. And does not give a realistic picture. A lot of what you say is true for doctors in their first 5-10 years into their career, when employed in a hospital. This not true for doctors which reached a certain level like „oberarzt“ and above. This is especially not true for doctors with their own „office“ (business). Yeah people may cry, but normally it is very hard to bring a…

Not sure how much you are actually in the business here, but almost everything you write is incorrect for literally every single doctor we know (cca 50, variously close, everything from GP to heart/neurosurgeons). You are clearly talking about German part, I talk about French, but still same general rules do apply.

Its trivial to sue a doctor, my wife, on her effin' first night shift in the country here got involved death of a patient and got into court case that took 6 months of court hearings to resolve. Not her fault, wasn't her patient even, but she still had to spent ridiculous amount of time for it outside work to get finally cleared.

Her colleague at this moment is getting sued, almost immediately after situation, for overlooking a cancer, when markers from test twice were non-conclusive (I don't/can't go into details, its a very complex case). Suing is very common here, its just that in case error can't be proved on their side, they have cca decent (and expensive) legal insurance. If they don't, license revocation, life-destroying fines, or even jail are on the table. Cases like this are common. This is very common for GPs with their own practice too, since they see more patients than some specialists.

Also not sure why you degrade other's people mental issues when under semi-constant decades of pressure from all sides. "Yeah people may cry" - this ain't how mental issues and burnout should be acknowledged. Please show some respect they properly deserve, you clearly are an outsider to profession and I sense some envy in between your lines. If its that bad with your life, go and start medicine studies, schools are open for anybody of any age and public schools here are free.

Last part - yes unemployment isn't generally high among doctors willing to work, but ie check canton Geneve now - no new GP licenses are granted (as = 0), and old folks are retiring fast. People are desperate to get a GP, I have colleagues begging me to find somebody via my wife for them, new doctors need to travel 2-3h every day to other cantons to find work, and some are properly desperate. As IT guy, I don't know a single capable colleague who has even similar employment issues, companies are always hiring good seniors, and there are tons of companies needing good IT folks left and right.

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