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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)

#421

Post by Take8435 »

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.

> Its also true that IT people are ridiculously overpaid

Hard disagree here. I don't feel I need to state the reasons. If much of a business relies upon technology that the IT people ensure is up and running for the non-IT folk, I would say that is not overpaid.

This is such a shallow opinion with no forethought into the domino effect. I won't try to make a commentary on doctors, because I am not a doctor and don't pretend to say that "doctors are ridiculously overpaid" because I know it would be a wasteful opinion that does nothing for the conversation.

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

#422

Post by sieabahlpark »

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…

[dead]

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

#423

Post by seadan83 »

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.

AMA is not a union, it's an association, akin to the National Association of Realtors, or even the "National Association of Photoshop Professionals." There are big differences between a professional association and a union. For starters, a Union would likely demand required overtime pay for the on-call shift, a cap of max hours worked, likely plenty more. I'm not in a position to judge whether those kinds of demands would be a positive or a negative, but it's a big example of a difference between a union and a professional association.

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

Ergo, AMA is not a union, hence that cannot be a flaw in the AMA. Chastising the AMA for not representing patients because it is too busy being a doctors union is a straw-man argument.

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

#424

Post by pc86 »

llamaimperative wrote: post #381
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…

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.

You can't "just" spend more on residency training without also "just" making med school classes bigger. You can't "just" expand med school classes without "just" increasing teaching staff, who are 9 times out of 10 physicians themselves. And very few physicians are going to willingly turn down $500k/yr clinical jobs to teach for a fraction of that.

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

#425

Post by nicomeemes »

billfruit wrote: post #302
throwaway20222 wrote: post #286

One of my friends I grew up with was “that kid;” smartest in the community, funny, played a mean guitar. Everyone loved him. Top of class. Harvard. Harvard med. Top placement for residency. Something happened during that time and he killed himself. It was absolutely unexpected from all of his friends. Shocking to say the least. Apparently it turned out to be stress from work, his hours, his fear of failing. Who will…

Can't medical doctors have duty time limits like aircrews. Wouldn't that alleviate some of the overwork.

There is such a restriction, at least for NY. It was prompted by a wealthy businessman (naturally): https://en.wikipedia.org/wiki/Libby_Zion_Law

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

#426

Post by pc86 »

shkkmo wrote: post #406
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…

> 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 doct…

I am wildly in favor of expanding the number of medical schools, expanding med school class sizes, expanding residency slots and funding per resident. None of this means I want decisions now made by someone who does 4 years of college, 4 years of med school, 3-7 years of residency and potentially fellowship on top of that to instead be made by a nurse "under the supervision" of a doctor. If you're a doctor of one specialty and you want to change specialties, you have to redo residency and maybe fellowship. If you're a nurse and you want to change specialties the training is either on-the-job or measured in days/weeks.

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

#427

Post by pc86 »

seadan83 wrote: post #423
willcipriano wrote: post #383

Earlier quoted context omitted.

> 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.

AMA is not a union, it's an association, akin to the National Association of Realtors, or even the "National Association of Photoshop Professionals." There are big differences between a professional association and a union. For starters, a Union would likely demand required overtime pay for the on-call shift, a cap of max hours worked, likely plenty more. I'm not in a position to judge whether those kinds of demands…

One thing that a generic union has in common with the AMA specifically is that both only care about its members, not anyone else, and will vehemently argue in favor of things that enrich its members at the direct expense of everyone else.

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

#428

Post by pc86 »

nradov wrote: post #404
willcipriano wrote: post #383

Earlier quoted context omitted.

> 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/

Which is pointless without also increasing the number of medical student slots.

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

#429

Post by pc86 »

Zambyte wrote: post #361
sambazi wrote: post #318

Earlier quoted context omitted.

then again, who does

In this case, people who rely on health services to live probably do.

The point was nobody likes their own salaries being depressed due to the free market. One difference is that doctors even under very free market conditions enjoy high salaries so it's comparatively pretty easy for them to set aside some money to lobby to tighten up that market - which gives them more money, which makes it even easier to ...

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

#430

Post by seadan83 »

thaumasiotes wrote: post #369
TeMPOraL wrote: post #333

Earlier quoted context omitted.

Yeah, but why is the same situation present, and the same explanation given, in Poland, EU? Or, seeing from other comments, plenty other countries around the world? I'm seconding 'viraptor here - this isn't a good enough explanation. It doesn't stand up to scrutiny, and doesn't mesh well with day-to-day experience. Individual doctors I know seem to have very little influence over anything, and they're first in line t…

There are a few factors: 1. Doctors have a lot of political influence because they are popular. This means they can get away with things that other industries mostly can't. 2. State provision of medical care corrupts the system, as I describe sidethread: https://news.ycombinator.com/item?id=40030452 One way to drive "medical costs" down is to ensure that the supply of medical care is low. This also drives prices up.…

> 2. State provision of medical care corrupts the system, as I describe sidethread

How is this at play (from the article we are commenting on)?

The article does not mention once: "medicare", "medicaid", "regulation", "law", "government" - once.

If anything, it's the inverse. You have it bass-ackwards, the private hospital, the for-profit system is driving things like:

> I delivered my third child with my own hands because the obstetrician was stuck in a traffic jam. The following morning I went to work because if I didn’t 12 patients have to miss their surgeries, 2 anaesthetists and about 8 nurses will miss out on their day’s income. More importantly, admin would not be happy because a cancelled operating list is a huge financial loss to the hospital.

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> 1. Doctors have a lot of political influence because they are popular. This means they can get away with things that other industries mostly can't.

Can you clarify how this doctor exerts any type of political influence? They have a sleeping bag in their car they sleep at their job so often and are lamenting they barely get to see their family. I don't see your point at all being illustrated in this article, at all.

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> "And doctors and hospitals are happy with this, because such a system boils down to telling them "we want you to do less work, but for more money".

I get the feeling this doctor is on the verge of suicide from being over-worked. Do you think the person that wrote this article would agree with your statement?

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