6 ms·

Maybe just maybe new young doctors should be treated (like not be worked to death) and paid properly then there would be plenty of people willing to take up the

Maybe just maybe new young doctors should be treated (like not be worked to death) and paid properly then there would be plenty of people willing to take up the profession and there would not be a shortaage

golem14 6y ago
Agreed that working conditions are atrocious and have been for years. But getting new doctors domestically from scratch will take years, and the article argues that there’s just not enough time for that.
- syshum 6y ago
  They have had said that for decades which was more than enough time to address the underlying issues. This will always be excuse "we have to act now, because X is terrible if we dont"
- Feolkin 6y ago
  The problem with that line of thinking is how it creates systems like the H1-B and doesn't really solve the problem of "we aren't educating enough doctors". Instead of thinking both long-term and short-term, the solution that's chosen now to solve the problem becomes the permanent solution going forward, and the solution for now is attracting foreign doctors instead of fixing medical education locally.
catalogia 6y ago
> Maybe just maybe new young doctors should be treated (like not be worked to death) and paid properly It seems to me, the tradition of working residents to the point of sleep exhaustion is a form of institutional hazing, perpetuated by people that endured it because "I did it, why shouldn't they?" I'm not sure how you crack that nut.
- GordonS 6y ago
  > I'm not sure how you crack that nut With regulation - for example, there could be a law that prevents doctors working more than 12 hours in a 24 hour period. Come to think of it, surely something like this exists already?
  - salawat 6y ago
    All that does is ensure no one gets fairly compensated for 12+ hours work, and shifts the complexity down the chain to accountants as people managers try to find other ways to compensate people for their extra effort. People don't stop being sick 12 hours in. It also unfairly hamstrings smaller practices with fewer covered professionals. Work gets offloaded from the covered individual to uncovered people in order to maximize the amount of work the covered individual can get done in that time span, or people start getting really particular about what is practicing and what isn't. Hate to sound like a broken record with other folks in the thread, but nothing is fundamentally changing the game with that regulation, just who pays the complexity tax at any one time does. So ball bustingly frustrating how bloody interconnected everything is while remaining so broad it's nigh-impossible to model within the confines of your own head. I say this as someone whose occupation centers around being able to very quickly jump between distinct verticals and subsystems while maintaining the capability to project the consequences of a change in one vertical through subsequently connected verticals. Everything seems to come back to a form of dynamic equilibrium where as long as you don't stare too hard the thing behaves well, but the closer you look the chaotic it becomes.
    - GordonS 6y ago
      > All that does is ensure no one gets fairly compensated for 12+ hours work, and shifts the complexity down the chain to accountants as people managers try to find other ways to compensate people for their extra effort. People don't stop being sick 12 hours in. Sorry, but this stance seems like part of the problem. Doctors shouldn't be working more than 12 hours at a time, for rather obvious safety reasons. People don't stop being sick, sure - that means you change the system so there are more doctors working fewer hours, rather than making doctors work insane hours that risk patients and are terrible for doctors' mental health and wellbeing.
rcpt 6y ago
They tried but everything medicine is hyper political in this country > The antitrust class-action lawsuit Jung v. AAMC alleged collusion to prevent American trainee doctors from negotiating for better working conditions. The working conditions of medical residents often involved 80- to 100-hour workweeks. The suit had some early success, but failed when the U.S. Congress enacted a statute exempting matching programs from federal antitrust laws https://en.m.wikipedia.org/wiki/Jung_v._Association_of_American_Medical_Colleges https://en.m.wikipedia.org/wiki/Jung_v._Association_of_Ameri...
raverbashing 6y ago
The "bootcamp"/"student filter" culture is strong in the medical field. The bad conditions on residencies is only part of it (long shifts, low pay, attrition, etc)

golem14 6y ago

Agreed that working conditions are atrocious and have been for years. But getting new doctors domestically from scratch will take years, and the article argues that there’s just not enough time for that.

syshum 6y ago
They have had said that for decades which was more than enough time to address the underlying issues. This will always be excuse "we have to act now, because X is terrible if we dont"
Feolkin 6y ago
The problem with that line of thinking is how it creates systems like the H1-B and doesn't really solve the problem of "we aren't educating enough doctors". Instead of thinking both long-term and short-term, the solution that's chosen now to solve the problem becomes the permanent solution going forward, and the solution for now is attracting foreign doctors instead of fixing medical education locally.

catalogia 6y ago

> Maybe just maybe new young doctors should be treated (like not be worked to death) and paid properly It seems to me, the tradition of working residents to the point of sleep exhaustion is a form of institutional hazing, perpetuated by people that endured it because "I did it, why shouldn't they?" I'm not sure how you crack that nut.

GordonS 6y ago
> I'm not sure how you crack that nut With regulation - for example, there could be a law that prevents doctors working more than 12 hours in a 24 hour period. Come to think of it, surely something like this exists already?
- salawat 6y ago
  All that does is ensure no one gets fairly compensated for 12+ hours work, and shifts the complexity down the chain to accountants as people managers try to find other ways to compensate people for their extra effort. People don't stop being sick 12 hours in. It also unfairly hamstrings smaller practices with fewer covered professionals. Work gets offloaded from the covered individual to uncovered people in order to maximize the amount of work the covered individual can get done in that time span, or people start getting really particular about what is practicing and what isn't. Hate to sound like a broken record with other folks in the thread, but nothing is fundamentally changing the game with that regulation, just who pays the complexity tax at any one time does. So ball bustingly frustrating how bloody interconnected everything is while remaining so broad it's nigh-impossible to model within the confines of your own head. I say this as someone whose occupation centers around being able to very quickly jump between distinct verticals and subsystems while maintaining the capability to project the consequences of a change in one vertical through subsequently connected verticals. Everything seems to come back to a form of dynamic equilibrium where as long as you don't stare too hard the thing behaves well, but the closer you look the chaotic it becomes.
  - GordonS 6y ago
    > All that does is ensure no one gets fairly compensated for 12+ hours work, and shifts the complexity down the chain to accountants as people managers try to find other ways to compensate people for their extra effort. People don't stop being sick 12 hours in. Sorry, but this stance seems like part of the problem. Doctors shouldn't be working more than 12 hours at a time, for rather obvious safety reasons. People don't stop being sick, sure - that means you change the system so there are more doctors working fewer hours, rather than making doctors work insane hours that risk patients and are terrible for doctors' mental health and wellbeing.

rcpt 6y ago

They tried but everything medicine is hyper political in this country > The antitrust class-action lawsuit Jung v. AAMC alleged collusion to prevent American trainee doctors from negotiating for better working conditions. The working conditions of medical residents often involved 80- to 100-hour workweeks. The suit had some early success, but failed when the U.S. Congress enacted a statute exempting matching programs from federal antitrust laws https://en.m.wikipedia.org/wiki/Jung_v._Association_of_American_Medical_Colleges https://en.m.wikipedia.org/wiki/Jung_v._Association_of_Ameri...

raverbashing 6y ago

The "bootcamp"/"student filter" culture is strong in the medical field. The bad conditions on residencies is only part of it (long shifts, low pay, attrition, etc)