4 ms·

That seems like it would raise a serious issue of moral hazard.

toomuchtodo 10y ago
Not if you pull the license of repeat offenders. F* up once? It happens, medicine is hard (EDIT: Document what went wrong, put a process in place so it doesn't happen again, issue a notice to all other medical facilities offering related procedures). F* up again? You're out of a job. No different then how the FAA and the NTSB operate. EDIT: Medicine can be made safer through the same processes used to ensure air travel is the safest transport method in the world. It can't be as safe, but we can do better.
- rplst8 10y ago
  I disagree entirely. People are known to be fallible. Processes prevent things from accidentally happening. In areas where the life of someone or a large organizational failure hangs in the balance of an action, that action should be wrapped in process to ensure it's correct execution, with fail-safe mechanisms put in place. Further, these systems should be audited on a regular basis to ensure compliance. Only in the case of purposeful or willful action or absolute gross negligence or being found unfit for duty (mentally or physically) should someone have their life ruined by removing their status/job/career path.
  - deleted 10y ago
    [deleted]
  - ryanlol 10y ago
    >Only in the case of purposeful or willful action or absolute gross negligence or being found unfit for duty (mentally or physically) should someone have their life ruined by removing their status/job/career path. Seriously? Losing your job hardly means that your life is ruined.
    - jleader 10y ago
      So you're advocating forgiving the educational loans of doctors who lose their license? Or do you leave them massively in debt, without the (relatively) lucrative profession they had assumed would allow them to pay off that debt?
      - ryanlol 10y ago
        I'm not advocating anything. I'm just saying that losing your job/career/whatever doesn't equal a ruined life.
      - toomuchtodo 10y ago
        > So you're advocating forgiving the educational loans of doctors who lose their license? Yes, although the better solution is to subsidize the education of medical providers directly, instead of burdening them with massive loans that take decades to repay. That's an argument for another thread though.
    - thebokehwokeh2 10y ago
      More than any other occupation, doctors spend a majority of their young adult lives learning about medicine and everything related to it. By removing them of their license to practice that, you've essentially stripped them of their life's purpose.
      - ryanlol 10y ago
        I don't think any of the doctors I've met would consider medicine their life's purpose. Most people seem to have much more mundane goals.
      - neurotech1 10y ago
        They could still work as a research physician, or work for medical device manufacturer or drug company. If they are really bad at clinical practice, they might get a job on a TV show. Psychologist Dr Phil McGraw [0] stopped practicing after an investigation, and ended up as a talk show host. [0] https://en.wikipedia.org/wiki/Phil_McGraw https://en.wikipedia.org/wiki/Phil_McGraw
  - DanBC 10y ago
    > Only in the case of purposeful or willful action or absolute gross negligence or being found unfit for duty (mentally or physically) should someone have their life ruined by removing their status/job/career path. Yes, and that "loss of job" or professional de-registration means many doctors do not seek help for mental illness. That might be one reason the suicide rate in doctors is so high. (Knowledge of effective methods; access to means and methods; and work stress are other reasons). In the UK Louis Appleby (who does a lot around suicide prevention in England) is doing some work with the General Medical Council (one of the regulators of doctors) around suicide prevention for doctors who are being investigated by GMC during fitness to practice. http://www.gmc-uk.org/Suicide_review___Final_Draft_Proposals_for_Publication___FINAL___20160418.pdf_65748529.pdf http://www.gmc-uk.org/Suicide_review___Final_Draft_Proposals... It also means doctors are more risky for patients. We need a way for doctors to seek help that protects them and their patients.
wskinner 10y ago
I would describe being fired if you f* up again as being held liable. Liability doesn't have to be monetary.
maxxxxx 10y ago
Everybody makes serious errors from time to time. At least me and everybody I know. You should be able to admit them without losing your career or being ruined. Obviously if somebody makes a lot more errors than others he should lose his job. My point is that the current system encourages denial and cover up. It doesn't encourage improvement.
lmm 10y ago
I don't think anyone wants to kill their patients. So what's the adverse scenario here? Doctors being paid per-operation and skipping safety steps? Doctors wanting to make a name for themselves and taking on ambitious surgeries that shouldn't be done? It seems like you could cover those cases without making individual doctors massively liable for essentially random mistakes.

Not if you pull the license of repeat offenders. F* up once? It happens, medicine is hard (EDIT: Document what went wrong, put a process in place so it doesn't happen again, issue a notice to all other medical facilities offering related procedures). F* up again? You're out of a job. No different then how the FAA and the NTSB operate. EDIT: Medicine can be made safer through the same processes used to ensure air travel is the safest transport method in the world. It can't be as safe, but we can do better.

rplst8 10y ago
I disagree entirely. People are known to be fallible. Processes prevent things from accidentally happening. In areas where the life of someone or a large organizational failure hangs in the balance of an action, that action should be wrapped in process to ensure it's correct execution, with fail-safe mechanisms put in place. Further, these systems should be audited on a regular basis to ensure compliance. Only in the case of purposeful or willful action or absolute gross negligence or being found unfit for duty (mentally or physically) should someone have their life ruined by removing their status/job/career path.
- deleted 10y ago
  [deleted]
- ryanlol 10y ago
  >Only in the case of purposeful or willful action or absolute gross negligence or being found unfit for duty (mentally or physically) should someone have their life ruined by removing their status/job/career path. Seriously? Losing your job hardly means that your life is ruined.
  - jleader 10y ago
    So you're advocating forgiving the educational loans of doctors who lose their license? Or do you leave them massively in debt, without the (relatively) lucrative profession they had assumed would allow them to pay off that debt?
    - ryanlol 10y ago
      I'm not advocating anything. I'm just saying that losing your job/career/whatever doesn't equal a ruined life.
    - toomuchtodo 10y ago
      > So you're advocating forgiving the educational loans of doctors who lose their license? Yes, although the better solution is to subsidize the education of medical providers directly, instead of burdening them with massive loans that take decades to repay. That's an argument for another thread though.
  - thebokehwokeh2 10y ago
    More than any other occupation, doctors spend a majority of their young adult lives learning about medicine and everything related to it. By removing them of their license to practice that, you've essentially stripped them of their life's purpose.
    - ryanlol 10y ago
      I don't think any of the doctors I've met would consider medicine their life's purpose. Most people seem to have much more mundane goals.
    - neurotech1 10y ago
      They could still work as a research physician, or work for medical device manufacturer or drug company. If they are really bad at clinical practice, they might get a job on a TV show. Psychologist Dr Phil McGraw [0] stopped practicing after an investigation, and ended up as a talk show host. [0] https://en.wikipedia.org/wiki/Phil_McGraw https://en.wikipedia.org/wiki/Phil_McGraw
- DanBC 10y ago
  > Only in the case of purposeful or willful action or absolute gross negligence or being found unfit for duty (mentally or physically) should someone have their life ruined by removing their status/job/career path. Yes, and that "loss of job" or professional de-registration means many doctors do not seek help for mental illness. That might be one reason the suicide rate in doctors is so high. (Knowledge of effective methods; access to means and methods; and work stress are other reasons). In the UK Louis Appleby (who does a lot around suicide prevention in England) is doing some work with the General Medical Council (one of the regulators of doctors) around suicide prevention for doctors who are being investigated by GMC during fitness to practice. http://www.gmc-uk.org/Suicide_review___Final_Draft_Proposals_for_Publication___FINAL___20160418.pdf_65748529.pdf http://www.gmc-uk.org/Suicide_review___Final_Draft_Proposals... It also means doctors are more risky for patients. We need a way for doctors to seek help that protects them and their patients.

wskinner 10y ago

I would describe being fired if you f* up again as being held liable. Liability doesn't have to be monetary.

maxxxxx 10y ago

Everybody makes serious errors from time to time. At least me and everybody I know. You should be able to admit them without losing your career or being ruined. Obviously if somebody makes a lot more errors than others he should lose his job. My point is that the current system encourages denial and cover up. It doesn't encourage improvement.

lmm 10y ago

I don't think anyone wants to kill their patients. So what's the adverse scenario here? Doctors being paid per-operation and skipping safety steps? Doctors wanting to make a name for themselves and taking on ambitious surgeries that shouldn't be done? It seems like you could cover those cases without making individual doctors massively liable for essentially random mistakes.