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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)

#401

Post by trixjo »

toldyouso2022 wrote: post #251
bsdz wrote: 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

[dead]

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

#402

Post by cmiles74 »

zelphirkalt wrote: post #330
Zenzero wrote: post #246

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…

I have to disagree on the "aversion to technology" point. It's something I've heard ever since I started working in software development, this isn't isolated to healthcare.

For sure, there is always some resistance to the extra work of learning something new. In my experience over many years, it's easy to overcome this resistance by showing clear improvement achieved by the new process, whatever it might be (change in order of process steps, new paper from, new software, etc.)

After working in healthcare (mid sized hospital), there is a big problem with pressure from administration that often makes little to no sense to those whose work is changing. I think a lot of this comes from weird incentives that maybe make sense in terms of short term business gain but, perhaps, are not worth the disruption to so many people's day-to-day work.

Lastly, in the field of enterprise software and healthcare in particular, I agree that many of the technical solutions are not great. There's a lot of resistance to changing software tools simply because people have changed so often and the tools are so poor. Often these tools do not come close to the promised improvement.

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

#403

Post by matheusmoreira »

bsdz wrote: 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…

> Something I've never quite understood is why, in the UK, we cap the number of medical students per year.

To keep salaries high.

I'm brazilian. In recent years, brazilian medical schools have been "democratized", so to speak. The number of medical schools has exploded and acceptance of doctors from neighboring south american countries has been facilitated. About 50 thousand new doctors enter the market every year.

Result? Pathetic salaries. Actual unemployment. Doctors fighting each other over the shittiest jobs with the worst working conditions. Doctors becoming Uber drivers. Complete loss of the prestige the profession once enjoyed. Rampant charlatanism and unethical conduct. Badly educated doctors who kill their patients. Dishonest doctors promising miracle cures on Instagram because that's what gets them engagement and therefore patients.

There is no reason whatsoever to become a doctor under these conditions. Too much responsibility, too little reward. You're better off doing literally anything else.

Society needs to carefully consider the needs of those who will be responsible for other people's lives. When responsibility does not equal reward, it's pointless. My society chose to treat those people with absolute contempt. The results are plain to see.

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

#404

Post by nradov »

willcipriano wrote: post #383
zahma wrote: post #380

Earlier quoted context omitted.

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.

The American Medical Association says ... we need more doctors and Congress should increase Medicare funding for residency programs.

https://savegme.org/

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

#405

Post by Aeolun »

I always find it odd when I see doctors saying stuff like "I have a duty of care, so I work 24/7 if I need to." I dunno about doctors, but after 12 hours of work my mind is toast, and I wouldn't trust myself to operate a toaster. I find it really hard to imagine the same thing does not apply to them.

Is an absent doctor really worse than an exhausted one? I mean, there's obvious situations in which this is the case, but is it true on average? If someone arrives at the hospital and dies because there is no doctor available, only for that doctor to go and save 3 people that might have otherwise died the next day because they're not exhausted, should we make that tradeoff?

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

#406

Post by shkkmo »

zahma wrote: post #380
toldyouso2022 wrote: post #251

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…

> 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 underlying fact that the AMA is directly responsible for the doctor shortage in the USA is historically accurate. 20 years ago the AMA believes we were heading towards a doctor surplus and heavily lobbied and for fewer medical schools, caps on federal funding for residencies and big cuts to the available residencies.

The AMA has reversed course and no longer supports these positions but the damage has been done, both to our supply of doctors and to their own reputation. However, even today the AMA supports many policies that keep taks that other professionals could perform the sole purview of doctors (which excacerbates the suppoy problem they helped create.)

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

#407

Post by d0gsg0w00f »

nojvek wrote: post #368

> I went into medicine knowing that I will have to sacrifice much for the sake of my patients. What I am realising is that today in modern medicine, a doctor is just one of the many commodities in this complex industry. It’s no longer about the patient. It’s about the business of hospitals. Patient satisfaction officers, Theatre Utilisation officers, Patient Flow Coordinators. These are all business roles. I have to…

Re pilots vs doctors: pilots would be the equivalent of elective surgery, i.e., it can wait.

There are so few doctors that getting a tired doctor is "better than nothing" as you have a greater chance of survival if you get mediocre care vs no care at all and certain death.

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

#408

Post by psychlops »

worik wrote: post #241
psychlops wrote: post #186

Earlier quoted context omitted.

The goal of a union is to put a fence around the employers and drive wages up. Mission accomplished.

> The goal of a union is to put a fence around the employers and drive wages up Feeding the troll: The role of a union is to represent the interests of their members

Fair enough, I'll revise my statement: the side effect of a union is to put a fence around the employers and drive wages up.

While you've identified their stated purpose, I can assure you after having been in multiple unions that they serve themselves first, then their members.

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

#409

Post by philwelch »

zahma wrote: post #380
toldyouso2022 wrote: post #251

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?

Yes. What’s difficult to believe about this? People respond to incentives. The incentive for every physician is to maintain a shortage of physicians, therefore improving the job security and earning potential of every physician. The only way this could be done is if the physicians formed some sort of cartel that could control how many people were allowed to become physicians. This is what the AMA is and what it verifiably does.

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

#410

Post by philwelch »

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…

In the UK, the NHS primarily exists as a mechanism for rationing medical care. If you compare how much every industrialized country spends on medical care, there’s a very strong correlation with GDP—the richer a country is, the more money they spend on medical care, and the higher proportion of GDP goes to medical care. The UK is uniquely below this trendline, indicating a de facto policy of artificial rationing.
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