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> today, in more educated circles at least in my observation, doctors are just body mechanics. They derive most of their status from their pay. ...WTF? Is it e

> today, in more educated circles at least in my observation, doctors are just body mechanics. They derive most of their status from their pay. ...WTF? Is it even possible to write a more egotistical comment? Most doctors (especially surgeons, etc.), along with firefighters, police, etc. derive their respect in "educated circles" not from their pay (that's some of the worst nonsense I've heard this week) but from the kind of work that they do: saving other people's lives, especially in situations where one small mistake on their end can prove fatal for one or more parties involved. That's quite sufficient to deserve a ton of respect just by itself....

omegaham 10y ago
> one small mistake on their end can prove fatal for one or more parties involved This right here is why I respect the hell out of doctors. Every morning, they wake up with the knowledge that today, they could kill someone through inattention or ignorance. I'm sure that they don't think about it that way while brushing their teeth or whatever, but that's an awesome responsibility.
- Johnny555 10y ago
  Do you share the same respect for airline pilots, bus drivers, crane operators and all of the other occupations that can kill multiple people through inattention or ignorance?
  - truth_sentinell 10y ago
    Hell, even software programmers can kill a lot of people by letting a bug slide. But I agree that in general, doctors have a bigger and more direct responsability in that matter.
  - makingithappen 10y ago
    I do respect those people, but the comparison to my profession is ludicrous. Here's what happened just today at work for me: Before noon, I received two patients in septic shock. Both required intubation and central lines. One required a chest tube. Early in the afternoon I had my finger directly compressing a carotid artery that was spraying across the room as my staff tried to call in the vascular surgeon. Around 1800 PM I got a rapid GI bleeder who died spilling blood out both ends. Because it happened within 24 hours of an admission, the medical examiner had to be involved. She was young. One other existing patient in the ICU died of septic shock around 2000. I stayed until well past midnight talking to families, putting out fires, dealing with loose ends and spending time with the floor residents to make sure they know how to handle events like this without having a breakdown (not that I've figured it out yet). I just got home and will have to go back in about 5 hours from now and face who-knows-what. My friend, a neurosurgeon, is still in the neuro-ICU at this hour (it's about 0100 local time). Oh and flu season is coming up; that's when shit really hits the fan. I realize that isn't a typical day for most doctors (nor is it a routine day for me; but not a rare one either), but it is demeaning to suggest that the emotional impact of this kind of work or the relationships developed therein could be even remotely comparable to that of an airline pilot with his/her passengers. Oh, and I don't get paid a dime extra for being there 18 hours and assuming a bunch of extra risk. If the patient who's neck bled all over after surgery at another hospital decides to sue, I'll get added to the lawsuit, even though we saved his life. My point is not to demand "respect" or elevate myself above anyone else; I come from a pretty humble family and stayed that way for the most part. I simply don't think anybody has a comparable work environment, especially the emotional side, which is very hard to describe to other people. As for the parent post: opioid prescribing is complicated and is going to get worse as our "performance" becomes tied to patient satisfaction surveys. Won't affect me much, but will be a very difficult balance for primary care doctors.
    - Pyxl101 10y ago
      What causes that kind of rapid GI bleeding?
      - makingithappen 10y ago
        Almost certainly an ulcer in the stomach or duodenum, especially given her medication use. If the ulcer erodes an artery, it can be catastrophic. Just not common to see it someone as young as she was. About 5-10% of "lower" GI bleeds are actually rapid upper GI bleeds. Easy to miss.
        lr4444lr 10y ago
        Yikes. What medications are known to have this side effect and what early warning symptoms of it can one heed?
    - roel_v 10y ago
      Paramedics/first responders save lives too, in scenes just as dramatic or more as yours. Is being a paramedic 'high status'? No it's not. Look I'm not here to tell you or anyone anything about how useful or stressful their jobs are; hell I mean I sit at a desk all day writimg code that'll be run by 10 people ever if I'm lucky. What I'm saying is that status doesn't depend on any of that, or on how hard you work, or on how hard you studied. I'm not making any claims about whether that's right or not either, just describing reality. Or how about this - does your boss still do the things you describe? If your hospital is medium sized or bigger, he spends half his day pushing paper and the other half controlling petty infighting between the surgeons. Yet is his job lower status than yours? Would getting his job, for you, be a demotion or a promotion? Seems to me the answers are pretty obvious.
    - cmdrfred 10y ago
      Ask someone who served in Iraq about his time there, it would make your day look like puppies and sunshine. Should we defer to jarheads on all matters of domestic policy?
    - erelde 10y ago
roel_v 10y ago
Yeah, way to quote out of context. "Most doctors (especially surgeons, etc.), along with firefighters, police, etc. derive their respect in "educated circles" not from their pay (that's some of the worst nonsense I've heard this week) but from the kind of work that they do: saving other people's lives, esp" Ah yes, the 'everybody deserves a medal' mentality. Let's not forget the garbage man, without whom we'd be choking on our own garbage! Praise his selfless sacrifice! In the mean time here in the real world, those firefighters and policemen you talk about are (in the case of firemen) replaced with volunteers, and paid a very basic wage (yes yes because of political/union dynamics some of that group in some US states are paid well with early retirement yadda yadda yadda - I'm talking in general). Way to show status and respect, society! In the mean time you're spinning a straw man of how I supposedly look down upon doctors, where my actual point is that doctors aren't that special intellectually speaking. Most people reading this could be doctors if they wanted to. Does that mean we look on them? No. But it does mean we don't put them on some pedestal as if they're so smart - which is what used to happen when the majority of people had no or very little education.
angersock 10y ago
One might note that the respect due to "police" is in decline, as people are wising up to their thuggery and lack of expertise and morality. > saving other people's lives, especially in situations where one small mistake on their end can prove fatal for one or more parties involved. Which is why their incompetence has risen to the third-leading cause of death in the United States ( https://www.washingtonpost.com/news/to-your-health/wp/2016/05/03/researchers-medical-errors-now-third-leading-cause-of-death-in-united-states/ https://www.washingtonpost.com/news/to-your-health/wp/2016/0... ). There are a lot of doctors (and especially nurses!) that provide valuable care every day. That said, we can't just blindly assume they know what they're doing and give them respect that they haven't earned--especially when the healthcare system is as fucked as it is today and they refuse to take an active role in fixing it.

omegaham 10y ago

> one small mistake on their end can prove fatal for one or more parties involved This right here is why I respect the hell out of doctors. Every morning, they wake up with the knowledge that today, they could kill someone through inattention or ignorance. I'm sure that they don't think about it that way while brushing their teeth or whatever, but that's an awesome responsibility.

Johnny555 10y ago
Do you share the same respect for airline pilots, bus drivers, crane operators and all of the other occupations that can kill multiple people through inattention or ignorance?
- truth_sentinell 10y ago
  Hell, even software programmers can kill a lot of people by letting a bug slide. But I agree that in general, doctors have a bigger and more direct responsability in that matter.
- makingithappen 10y ago
  I do respect those people, but the comparison to my profession is ludicrous. Here's what happened just today at work for me: Before noon, I received two patients in septic shock. Both required intubation and central lines. One required a chest tube. Early in the afternoon I had my finger directly compressing a carotid artery that was spraying across the room as my staff tried to call in the vascular surgeon. Around 1800 PM I got a rapid GI bleeder who died spilling blood out both ends. Because it happened within 24 hours of an admission, the medical examiner had to be involved. She was young. One other existing patient in the ICU died of septic shock around 2000. I stayed until well past midnight talking to families, putting out fires, dealing with loose ends and spending time with the floor residents to make sure they know how to handle events like this without having a breakdown (not that I've figured it out yet). I just got home and will have to go back in about 5 hours from now and face who-knows-what. My friend, a neurosurgeon, is still in the neuro-ICU at this hour (it's about 0100 local time). Oh and flu season is coming up; that's when shit really hits the fan. I realize that isn't a typical day for most doctors (nor is it a routine day for me; but not a rare one either), but it is demeaning to suggest that the emotional impact of this kind of work or the relationships developed therein could be even remotely comparable to that of an airline pilot with his/her passengers. Oh, and I don't get paid a dime extra for being there 18 hours and assuming a bunch of extra risk. If the patient who's neck bled all over after surgery at another hospital decides to sue, I'll get added to the lawsuit, even though we saved his life. My point is not to demand "respect" or elevate myself above anyone else; I come from a pretty humble family and stayed that way for the most part. I simply don't think anybody has a comparable work environment, especially the emotional side, which is very hard to describe to other people. As for the parent post: opioid prescribing is complicated and is going to get worse as our "performance" becomes tied to patient satisfaction surveys. Won't affect me much, but will be a very difficult balance for primary care doctors.
  - Pyxl101 10y ago
    What causes that kind of rapid GI bleeding?
    - makingithappen 10y ago
      Almost certainly an ulcer in the stomach or duodenum, especially given her medication use. If the ulcer erodes an artery, it can be catastrophic. Just not common to see it someone as young as she was. About 5-10% of "lower" GI bleeds are actually rapid upper GI bleeds. Easy to miss.
      - lr4444lr 10y ago
        Yikes. What medications are known to have this side effect and what early warning symptoms of it can one heed?
  - roel_v 10y ago
    Paramedics/first responders save lives too, in scenes just as dramatic or more as yours. Is being a paramedic 'high status'? No it's not. Look I'm not here to tell you or anyone anything about how useful or stressful their jobs are; hell I mean I sit at a desk all day writimg code that'll be run by 10 people ever if I'm lucky. What I'm saying is that status doesn't depend on any of that, or on how hard you work, or on how hard you studied. I'm not making any claims about whether that's right or not either, just describing reality. Or how about this - does your boss still do the things you describe? If your hospital is medium sized or bigger, he spends half his day pushing paper and the other half controlling petty infighting between the surgeons. Yet is his job lower status than yours? Would getting his job, for you, be a demotion or a promotion? Seems to me the answers are pretty obvious.
  - cmdrfred 10y ago
    Ask someone who served in Iraq about his time there, it would make your day look like puppies and sunshine. Should we defer to jarheads on all matters of domestic policy?
  - erelde 10y ago

roel_v 10y ago

Yeah, way to quote out of context. "Most doctors (especially surgeons, etc.), along with firefighters, police, etc. derive their respect in "educated circles" not from their pay (that's some of the worst nonsense I've heard this week) but from the kind of work that they do: saving other people's lives, esp" Ah yes, the 'everybody deserves a medal' mentality. Let's not forget the garbage man, without whom we'd be choking on our own garbage! Praise his selfless sacrifice! In the mean time here in the real world, those firefighters and policemen you talk about are (in the case of firemen) replaced with volunteers, and paid a very basic wage (yes yes because of political/union dynamics some of that group in some US states are paid well with early retirement yadda yadda yadda - I'm talking in general). Way to show status and respect, society! In the mean time you're spinning a straw man of how I supposedly look down upon doctors, where my actual point is that doctors aren't that special intellectually speaking. Most people reading this could be doctors if they wanted to. Does that mean we look on them? No. But it does mean we don't put them on some pedestal as if they're so smart - which is what used to happen when the majority of people had no or very little education.

angersock 10y ago

One might note that the respect due to "police" is in decline, as people are wising up to their thuggery and lack of expertise and morality. > saving other people's lives, especially in situations where one small mistake on their end can prove fatal for one or more parties involved. Which is why their incompetence has risen to the third-leading cause of death in the United States ( https://www.washingtonpost.com/news/to-your-health/wp/2016/05/03/researchers-medical-errors-now-third-leading-cause-of-death-in-united-states/ https://www.washingtonpost.com/news/to-your-health/wp/2016/0... ). There are a lot of doctors (and especially nurses!) that provide valuable care every day. That said, we can't just blindly assume they know what they're doing and give them respect that they haven't earned--especially when the healthcare system is as fucked as it is today and they refuse to take an active role in fixing it.