4 ms·

When This War Is Over, Many of Us Will Leave Medicine

27 points by TakakiTohno 6y ago

PeterStuer 6y ago
The system is failing. Hard. It has been for decades. Society was robbed for profits while sly politicians from all sides and parties got voted in because they always found someone else to blame while serving their corporate masters. Now science, already under attack where not co-opted when it stood in the way of more profits, sold it's soul by keeping quiet while bogus about PPE and 'social distancing' got and is peddled to the public. Will something rise from the ashes? For now our 'rulers' seem hell bent on doubling and tripling down on the same course that got us here in the first place.
tinus_hn 6y ago
I have never understood why people in healthcare accept 12 hour or longer shifts in normal times. Now it’s coming back to haunt them. If normally they would have worked 8 hour shifts there would be more workers and now, in an emergency, there would be room to expand.
- tdeck 6y ago
  Every time I talk to someone familiar with medical residency here in the US I hear something knew that shocks me. For those not familiar, residency is basically a multi-year apprenticeship after medical school that you need to do in order to complete your medical training. The federal government pays institutions about $140k (iirc) to train residents, in return the residents get around $60k and do a ton of the day-to-day doctoring work in a hospital. A few years ago a law was passed that they could "only" work 80 hours a week, but I've heard from multiple people that everyone works more than that and just lies on their time sheet. In order to get a residency you have to fly around to 20-40 different institutions at your own expense and interview, during which you will be asked illegal questions about your relationship status, plans to have children, etc... that your medical school has prepared you for in advance. My sense is that the whole thing is a series of hazing rituals that aspiring doctors feel like they've got to endure, but there's also a huge guilt component to it. Hospitals and other institutions don't have enough residents to do the work that needs to be done at 80 hours per person, and most people go into the field to help people, so they just make the sacrifice over and over. I think it's exploitive and shitty and other countries probably have a better system.
  - jazoom 6y ago
    I'm an Australian doctor. We have some problems, but it's sure as hell better than what you just described.
  - _bxg1 6y ago
    As a rule, I think any job field that people are consistently self-motivated about ends up converging towards exploitation of that motivation. Just look at game development, academia, animation. People in these fields are chronically over-worked for too-little pay, because organizations just let passion subsidize their salaries.
  - monkeydreams 6y ago
    I believe that medicine is one of the last guild systems, protected by law, and encumbered by all the rites and burdens thereof. The young acolytes are exploited by the old masters in return for an education which all claim cannot be delivered through any other mechanism (and actively preventing all attempts to try). The young must constantly prove themselves worthy of medicine, and the promise of future earnings and social standing (along with all the benefits of mastery within the system), and a guild master can lay any number of traps in the path of a prospective but unpopular aspirant in order to trip them up and toss them out.
chrisbennet 6y ago
I thought I'd read that medical errors happen more often when doctors switch over than when (even very tired) doctors work longer.

27 points by TakakiTohno 6y ago

The system is failing. Hard. It has been for decades. Society was robbed for profits while sly politicians from all sides and parties got voted in because they always found someone else to blame while serving their corporate masters. Now science, already under attack where not co-opted when it stood in the way of more profits, sold it's soul by keeping quiet while bogus about PPE and 'social distancing' got and is peddled to the public. Will something rise from the ashes? For now our 'rulers' seem hell bent on doubling and tripling down on the same course that got us here in the first place.

tinus_hn 6y ago

I have never understood why people in healthcare accept 12 hour or longer shifts in normal times. Now it’s coming back to haunt them. If normally they would have worked 8 hour shifts there would be more workers and now, in an emergency, there would be room to expand.

tdeck 6y ago
Every time I talk to someone familiar with medical residency here in the US I hear something knew that shocks me. For those not familiar, residency is basically a multi-year apprenticeship after medical school that you need to do in order to complete your medical training. The federal government pays institutions about $140k (iirc) to train residents, in return the residents get around $60k and do a ton of the day-to-day doctoring work in a hospital. A few years ago a law was passed that they could "only" work 80 hours a week, but I've heard from multiple people that everyone works more than that and just lies on their time sheet. In order to get a residency you have to fly around to 20-40 different institutions at your own expense and interview, during which you will be asked illegal questions about your relationship status, plans to have children, etc... that your medical school has prepared you for in advance. My sense is that the whole thing is a series of hazing rituals that aspiring doctors feel like they've got to endure, but there's also a huge guilt component to it. Hospitals and other institutions don't have enough residents to do the work that needs to be done at 80 hours per person, and most people go into the field to help people, so they just make the sacrifice over and over. I think it's exploitive and shitty and other countries probably have a better system.
- jazoom 6y ago
  I'm an Australian doctor. We have some problems, but it's sure as hell better than what you just described.
- _bxg1 6y ago
  As a rule, I think any job field that people are consistently self-motivated about ends up converging towards exploitation of that motivation. Just look at game development, academia, animation. People in these fields are chronically over-worked for too-little pay, because organizations just let passion subsidize their salaries.
- monkeydreams 6y ago
  I believe that medicine is one of the last guild systems, protected by law, and encumbered by all the rites and burdens thereof. The young acolytes are exploited by the old masters in return for an education which all claim cannot be delivered through any other mechanism (and actively preventing all attempts to try). The young must constantly prove themselves worthy of medicine, and the promise of future earnings and social standing (along with all the benefits of mastery within the system), and a guild master can lay any number of traps in the path of a prospective but unpopular aspirant in order to trip them up and toss them out.

chrisbennet 6y ago

I thought I'd read that medical errors happen more often when doctors switch over than when (even very tired) doctors work longer.