5 ms·

No, the scenario is a rural hospital in peacetime. It happens routinely.

jjoonathan 8y ago
... because the rural hospital can't afford to hire enough surgeons to cover their shifts, because we don't train enough surgeons, because we overtrain surgeons, because everybody qualified to evaluate this has incentives to lobby for more training. Lack of training is a perfect scapegoat for any problem and increased training requirements create lucrative educational opportunities and decrease supply / increase prices of qualified professionals. We know this in general because we can evaluate results against other regulatory regimes, but if you drill down to specifics you run into the problem that everyone qualified to comment has perverse incentives. The real question is how to push back.
- JasonFruit 8y ago
  I'm going to say, anecdotally, that I'm aware of surgeons I would hesitate to call overtrained.
  - jjoonathan 8y ago
    Let's define "overtrained" to mean "we spent too much money on training" rather than "the training resulted in an excess of competence." I am sure the latter does happen occasionally, or even frequently, but I am also completely willing to believe that sometimes it... doesn't.
- ameister14 8y ago
  Yep. That said, I don't believe charging them with manslaughter is the way to push back.
  - jjoonathan 8y ago
    Oh, agreed. I suspect doing so would just exacerbate the supply/demand issue further.
    - verelo 8y ago
      Why not? A pilot that works beyond their duty day will get a manslaughter charge if the flight results in the death of a passenger or person on the ground. Whats the difference?
      - jjoonathan 8y ago
        Morally? Nothing. Economically? Everything. We have an oversupply of pilots, so we can afford to be harsh/abusive without fear of it boomeranging.
      - ameister14 8y ago
        It's an extremely unusual situation where if a person isn't flown immediately, they will die. It isn't that rare for people to need immediate medical attention.

... because the rural hospital can't afford to hire enough surgeons to cover their shifts, because we don't train enough surgeons, because we overtrain surgeons, because everybody qualified to evaluate this has incentives to lobby for more training. Lack of training is a perfect scapegoat for any problem and increased training requirements create lucrative educational opportunities and decrease supply / increase prices of qualified professionals. We know this in general because we can evaluate results against other regulatory regimes, but if you drill down to specifics you run into the problem that everyone qualified to comment has perverse incentives. The real question is how to push back.

JasonFruit 8y ago
I'm going to say, anecdotally, that I'm aware of surgeons I would hesitate to call overtrained.
- jjoonathan 8y ago
  Let's define "overtrained" to mean "we spent too much money on training" rather than "the training resulted in an excess of competence." I am sure the latter does happen occasionally, or even frequently, but I am also completely willing to believe that sometimes it... doesn't.
ameister14 8y ago
Yep. That said, I don't believe charging them with manslaughter is the way to push back.
- jjoonathan 8y ago
  Oh, agreed. I suspect doing so would just exacerbate the supply/demand issue further.
  - verelo 8y ago
    Why not? A pilot that works beyond their duty day will get a manslaughter charge if the flight results in the death of a passenger or person on the ground. Whats the difference?
    - jjoonathan 8y ago
      Morally? Nothing. Economically? Everything. We have an oversupply of pilots, so we can afford to be harsh/abusive without fear of it boomeranging.
    - ameister14 8y ago
      It's an extremely unusual situation where if a person isn't flown immediately, they will die. It isn't that rare for people to need immediate medical attention.