The darker side of being a doctor (2017)

The answer is implied, right there in the first paragraph: "... I’ve never been diagnosed with a mental illness."

At least in the US, there's a kind of masochistic pride in the physician community, that everything he described in his essay is laudable, noble, to be emulated. Nowhere does he acknowledge the risks to his patients or whether the costs are worth it in the end, or if a different system might be better. And he's holding up the lack of mental illness diagnosis as if it's something to be proud of, as opposed to never being diagnosed with say, cardiovascular disease or cancer. He's proud he's never sought help or tried to change anything. Sure he mentions problems with patient care in passing, but what he's really upset about is "just being another employee".

In the end in his mindset whatever he's complaining about is better than the alternatives, which is ceding over some of the care responsibilities to others or opening up healthcare to a more competitive market so he's not the only provider who could provide those services (note the comment about denying other physicians income). The AMA and physicians union (yes it's a union) basically guarantees this in lieu of having real competition, decreased income, and so forth.

Why is it different in something like aviation? My guess is because the failures are more visible, they're on the nightly news, people are there posting pictures on social media? For whatever reason, I don't think pilot organizations ever managed to remove themselves from scrutiny in the same way as physicians did. We see pilots as highly skilled professionals, but part of a system, with alternatives, and the subject of fair scrutiny from outsiders who are not pilots: engineers, safety experts, investigators and so forth. In my experience when these kinds of issues come up in healthcare though, everyone defers to physician groups themselves, as if no one else has expertise enough to scrutinize them.

I imagine too at some level, part of the issue is that the pilots themselves are subject to their own mistakes: if a pilot crashes a plane, they take themselves out at the same time. If a surgeon makes a mistake and kills a patient, they still walk home and can rationalize whatever they want, all they want.

I'm growing unsympathetic to these types of essays (the one linked). If physicians want me to empathize with them more, maybe they should stop stigmatizing mental unwellness and recognize it in themselves. Maybe they as a professional group should admit that others could take on some of the load, maybe even better in some situations. It feels a bit like they create a mess out of selfish greed or ego and then expect me to feel bad for them.

there's more than 12 times the number of people in the US. Yes i understand this is "per 100k", but this still kind of reads like "adding lanes to highways does not reduce traffic," and that means that there is some other issue. If you have more doctors, more people will go to the doctor. This is good, more people should go to the doctor, because early and preventative care reduces the overall cost burden on the system.

And i don't want to put this in its own comment or even continue reading the defense of doctors (as they stand now): Women get shafted so hard by the medical community. People with mental health issues get screwed by the medical system. Both get their problems written off for non-medical reasons. There are bad practitioners just like there are bad developers and bad general contractors and bad bridge builders and bad pilots. The whole system is not very good and i don't see, necessarily, how merely adding more medical degree holding people to the mix will improve things. There isn't enough patient advocacy, there's too much friction with medical insurance (in the US).

But at least the shareholders are making money.

I think it's a matter of the 'tradinionalist' mindset in doctor education

most doctors will think "well, I went through a hardcore intesnse experience in medical school, therefore that's how it should be"

I'm saying they've normalized overwork as part of their specific subculture of modern medical professionals. they really believe they won't be as good doctors without this arguably abusive overwork system

it's yet another group of people who all belive in some form of the "no pain, no gain" mindset; the issue is these groups don't give nobody anything unless there's some harm or pain involved

Artificially limiting the supply of doctors is one way of rationing healthcare and holding down costs. Healthcare in the UK is largely funded through the NHS. Voters are already financially struggling and don't want to pay higher taxes. In some cases, even emergency patients are waiting hours in ambulances because hospitals are so overloaded.

https://www.bbc.com/news/uk-england-cornwall-68171254

I think, that is a bit besides the point I wanted to make.

Yes, it is very hard to know a priori, what is life-saving, and what not. No, I do not wanted to suggest that the work of doctors it is not important.

The common understanding of doctors (their self-understanding included) is, that their work is very important, to the point that they exploit themselves. Or allow themselves to be "exploited".

In this forum, more commonly you have people here working on productive systems, which can empathize with the feeling the responsibility for the operations and not wanting to drop the ball.

People with that mindset think, they may safe a patient / the system, but working oneself to exhaustion won't solve those problems. And on the contrary, the exhaustion may be a contributing factor of making things worse in various ways. One directly by your actions, the other indirectly by covering up systemic problems.