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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)

#451

Post by zahma »

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.

Why do we blame this on medical lobbies when it appears to be the same issue across the board for funding state education departments?

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

#452

Post by llamaimperative »

zahma wrote: post #451
llamaimperative wrote: post #381

Earlier quoted context omitted.

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.

Why do we blame this on medical lobbies when it appears to be the same issue across the board for funding state education departments?

Because it’s a different issue with different principals involved.

Does the federal government set the national number of teachers who can be trained each year?

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

#453

Post by zahma »

llamaimperative wrote: post #452
zahma wrote: post #451

Earlier quoted context omitted.

Why do we blame this on medical lobbies when it appears to be the same issue across the board for funding state education departments?

Because it’s a different issue with different principals involved. Does the federal government set the national number of teachers who can be trained each year?

I have no idea, but that’s not the point. The funding they put into each state’s education budget, combined with that state’s policy effectively limits hiring.

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

#454

Post by nradov »

pc86 wrote: post #428
nradov wrote: post #404

Earlier quoted context omitted.

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.

The AMA doesn't control the number of medical student slots either. They have no regulatory or accreditation authority. Medical schools are free to add more students, and several entire new medical schools have opened in the past few years.

https://www.deborahgutmanmd.com/blog/new-medical-schools-upd...

The immediate bottleneck really is in residency programs. Every year, some students graduate with an MD/DO degree but are unable to practice medicine because they don't get matched to a residency program.

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

#455

Post by game_the0ry »

shufflerofrocks wrote: post #415
game_the0ry wrote: post #88

I don't understand why doctors that are entering the field need to be over-staffed and over-worked. I have a cousin who is an Er surgeon and she needs works 3 days a week, but that certainly was not the case when she was starting out. The work culture of the medical profession looks horribly inefficient. What benefit do you get from buying out young doctors?

One thing is that the rigid terrific schedule of the modern-day residency program was designed by a cocaine addict who made the structure to fuel and hide his addiction, so all doctors start out with a skewed sense of normal working hours. ( https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7828946/ ) Another thing is the toxic culture perpetuated for allowing medicos to stroke their egos - toxic cultures about overtime a…

I remember hearing this story on the Joe Rogan podcast. I was so astonished, I could not believe it until I looked it up myself.

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

#456

Post by lesam »

refurb wrote: post #228
nextaccountic wrote: post #94

Earlier quoted context omitted.

Artificially limiting the supply of doctors drives the wages up. It's a common demand of doctors worldwide

Not if you're in the universal system where the government sets the payments. I do know that limiting the number of doctors is one of many mechanisms to limit healthcare spending. A doctor can only see so many patients in one day.

I’m in Canada. If there were enough doctors that doctor unemployment was 2%+, like a normal job, doctors here would get paid less. Also doctors might not burn themselves out working crazy hours.

Instead, we have a dire shortage of doctors and people in government employed full time trying to recruit the limited supply.

Doctors can’t move to the next hospital for more pay, but they can move to the next province, or to the US.

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

#457

Post by SJC_Hacker »

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.

Last I heard (this was early 2010s) at least it Texas, it was capped at 80 hours/week for residents. Seems like a lot but probably better than the 100+ they used to pull.

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

#458

Post by rtaylorgarlock »

d0gsg0w00f wrote: post #407
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.

Ironically, the reason my wife, a physician, gets to see her dad, a private pilot, most often is when he's flying medical teams to harvest organs from organ donors. 'Agreed' to your points, at least in part ;)

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

#459

Post by matthewdgreen »

pc86 wrote: post #434
llamaimperative wrote: post #433

Earlier quoted context omitted.

You’re describing problems that are all solved by money.

And time. You double the number of residency slots but it will take years to fill them if you increase med school size at the same time, a type of coordination that is very unlikely.

The supply of new doctors (and residents) should at least keep pace with population growth. For whatever reason, we spent nearly two decades keeping this number flat even as population grew by 70 million. We shouldn't have to double these numbers, they all should have organically increased at a reasonable pace. But for a variety of reasons they didn't and now we have to fix the problem.

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

#460

Post by jjackson5324 »

thaumasiotes wrote: post #367
jjackson5324 wrote: post #353

Earlier quoted context omitted.

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 organizatio…

Obviously, they are a big problem, but they're not the only problem. It is received wisdom among doctors that increasing the number of doctors causes medical costs to go up, and it is generally also the position of the state. The doctors are simply wrong; the state is correct from a pernicious point of view. Because the state is responsible for buying so much of the total supply of medical care, they generally view t…

So you’re saying that increasing the number of doctors will result in more medical services being consumed which means higher costs for the gov?

That’s the view of the government?

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