8 ms·

There are not enough nurses, and aren't enough doctors sitting idle right now to hire up in the way that you're suggesting... and if you thought spinning up a

There are not enough nurses, and aren't enough doctors sitting idle right now to hire up in the way that you're suggesting... and if you thought spinning up a chip fab in Texas is taking too long, wait until you try to solve the problem of spinning up more doctors. the residency program that takes up years of their schooling relies on having other doctors mentor them.

nradov 5y ago
At times there have been a lot of idle doctors and nurses. Hospitals cancelled elective procedures to reserve capacity for an expected surge of COVID-19 patients (which in most areas never really arrived). My neighbor is an anesthesiologist and was only working half time for months. Doctors can be retained for other specialties but it's a slow process.
RhodesianHunter 5y ago
There's actually an enormous abundance of nurses in the US. One in 100 people is a registered nurse. The nursing shortages are entirely due to the fact that these nurses have left bedside care due to the BS they have to deal with from understaffing, poor compensation, terrible shifts/hours, to abusive management and patients. The "nursing shortage" is as much a myth as the current labor shortage. There's only a shortage of nurses at current pay rates and working conditions.
- mumblemumble 5y ago
  And I think that this is very much a result of a market failure. In a lot of metro areas, the health care networks have been consolidating, so that a single company dominates the market. That creates a double problem. It's not just that they don't have to pay a reasonable market rate for staff. It's also that they don't have to maintain a reasonable staffing level, because dissatisfied and poorly-treated patients don't necessarily have anywhere else to go.
  - dantheman 5y ago
    Hard to call it a market failure when the government restricts new entrants and highly regulates every aspect of healthcare.
    - mumblemumble 5y ago
      At least in the clinic a family member of mine owned, regulation was far from the biggest challenge. It was billing, especially interacting with private health insurance companies. Dealing with their labyrinthine systems costs a lot of money and time. The private insurance companies are a big factor driving the consolidation, too. As the care networks consolidate their negotiating power, it gives them more and more of a competitive advantage over their smaller competitors, who have relatively less ability to negotiate good rates. That, in turn, leads to them having to drop off of the insurers' networks, which then results in patients being directed elsewhere. I certainly don't want to say that government influence has no influence, but the brand of capitalism that sees government as the source of all evil is more about politics than economics. Economically speaking, cartels and informal cartel-like systems can be just as harmful. You don't get a healthy, well-functioning market by indiscriminately yanking any one lever; you get it by carefully tending the garden, and balancing a lot of competing considerations.
      - dantheman 5y ago
        Where do you think these cartels get their power? Does the clinic post their prices online? Do they provide estimates on what care will cost before it happens? If insurance is costly and troublesome can you compete on a cost basis?
        mumblemumble 5y ago
        Posting prices online is infeasible because the system has been structured such that the price is different for everyone, depending not only on which health insurance company they use, if any, but also on which of that particular company's plans they have. And it's ever-shifting. Maintaining an online price sheet that is even accurate, let alone navigable, would only be feasible for large corporate entities, so expecting something like that to happen would only further advantage the oligarchy and undermine what remains of the free market in this sector. But what you can absolutely do is call and ask. Assuming you have the time to do so, of course. Urgent care does have a distressing tendency to be urgent. And it is wise to do so when you can. For a really pedestrian example, it's worth asking your pharmacist about the retail price of a drug before paying. If the retail price is lower than your prescription plan's copay - something that happens quite often - then there's no sense putting it on your insurance. And no, I don't think it's the pharmacist's job to keep track of that. The elephant in the room in this discussion is that American culture already does way too much shitting on service industry workers. We need less of that, not more.
- analog31 5y ago
  In my locale, a large percentage of doctors have switched to part time hours.
- dan_quixote 5y ago
  Anecdotally, I have at least 7 family/friends that were RNs at some point and moved on to other professions or dropped to part time. Zero of my family and friends are still full-time RNs. They cite a combination of reasons: risks from patients (moving overweight people, assault from patients, verbal abuse from patients/families, etc), increased workloads that threaten their licenses, and cost of childcare. And this all occurred before COVID.
jaywalk 5y ago
We should just put new doctors into an emergency six month fast track program.
- objectivetruth 5y ago
  Dude, I don't even trust the graduate of a six-month boot camp to touch my production code for a niche web app and you want to let one PERFORM HUMAN MEDICINE?!?!
- preordained 5y ago
  A bootcamp for doctors, that's the ticket!
rtkwe 5y ago
Pandemics in particular stress the system a lot because normally events the push hospitals to their limits are fairly localized and hospitals can borrow workers from elsewhere to fill out the staff. That happened early in 2020 in the US, some nurses made good money going from place to place as areas peaked in the early days of COVID. Private hospitals in particular are never going to be particularly amenable to keeping the kind of slack that would be required to handle a pandemic. They barely keep enough staff for normal operations.

nradov 5y ago

At times there have been a lot of idle doctors and nurses. Hospitals cancelled elective procedures to reserve capacity for an expected surge of COVID-19 patients (which in most areas never really arrived). My neighbor is an anesthesiologist and was only working half time for months. Doctors can be retained for other specialties but it's a slow process.

RhodesianHunter 5y ago

There's actually an enormous abundance of nurses in the US. One in 100 people is a registered nurse. The nursing shortages are entirely due to the fact that these nurses have left bedside care due to the BS they have to deal with from understaffing, poor compensation, terrible shifts/hours, to abusive management and patients. The "nursing shortage" is as much a myth as the current labor shortage. There's only a shortage of nurses at current pay rates and working conditions.

mumblemumble 5y ago
And I think that this is very much a result of a market failure. In a lot of metro areas, the health care networks have been consolidating, so that a single company dominates the market. That creates a double problem. It's not just that they don't have to pay a reasonable market rate for staff. It's also that they don't have to maintain a reasonable staffing level, because dissatisfied and poorly-treated patients don't necessarily have anywhere else to go.
- dantheman 5y ago
  Hard to call it a market failure when the government restricts new entrants and highly regulates every aspect of healthcare.
  - mumblemumble 5y ago
    At least in the clinic a family member of mine owned, regulation was far from the biggest challenge. It was billing, especially interacting with private health insurance companies. Dealing with their labyrinthine systems costs a lot of money and time. The private insurance companies are a big factor driving the consolidation, too. As the care networks consolidate their negotiating power, it gives them more and more of a competitive advantage over their smaller competitors, who have relatively less ability to negotiate good rates. That, in turn, leads to them having to drop off of the insurers' networks, which then results in patients being directed elsewhere. I certainly don't want to say that government influence has no influence, but the brand of capitalism that sees government as the source of all evil is more about politics than economics. Economically speaking, cartels and informal cartel-like systems can be just as harmful. You don't get a healthy, well-functioning market by indiscriminately yanking any one lever; you get it by carefully tending the garden, and balancing a lot of competing considerations.
    - dantheman 5y ago
      Where do you think these cartels get their power? Does the clinic post their prices online? Do they provide estimates on what care will cost before it happens? If insurance is costly and troublesome can you compete on a cost basis?
      - mumblemumble 5y ago
        Posting prices online is infeasible because the system has been structured such that the price is different for everyone, depending not only on which health insurance company they use, if any, but also on which of that particular company's plans they have. And it's ever-shifting. Maintaining an online price sheet that is even accurate, let alone navigable, would only be feasible for large corporate entities, so expecting something like that to happen would only further advantage the oligarchy and undermine what remains of the free market in this sector. But what you can absolutely do is call and ask. Assuming you have the time to do so, of course. Urgent care does have a distressing tendency to be urgent. And it is wise to do so when you can. For a really pedestrian example, it's worth asking your pharmacist about the retail price of a drug before paying. If the retail price is lower than your prescription plan's copay - something that happens quite often - then there's no sense putting it on your insurance. And no, I don't think it's the pharmacist's job to keep track of that. The elephant in the room in this discussion is that American culture already does way too much shitting on service industry workers. We need less of that, not more.
analog31 5y ago
In my locale, a large percentage of doctors have switched to part time hours.
dan_quixote 5y ago
Anecdotally, I have at least 7 family/friends that were RNs at some point and moved on to other professions or dropped to part time. Zero of my family and friends are still full-time RNs. They cite a combination of reasons: risks from patients (moving overweight people, assault from patients, verbal abuse from patients/families, etc), increased workloads that threaten their licenses, and cost of childcare. And this all occurred before COVID.

jaywalk 5y ago

We should just put new doctors into an emergency six month fast track program.

objectivetruth 5y ago
Dude, I don't even trust the graduate of a six-month boot camp to touch my production code for a niche web app and you want to let one PERFORM HUMAN MEDICINE?!?!
preordained 5y ago
A bootcamp for doctors, that's the ticket!

rtkwe 5y ago

Pandemics in particular stress the system a lot because normally events the push hospitals to their limits are fairly localized and hospitals can borrow workers from elsewhere to fill out the staff. That happened early in 2020 in the US, some nurses made good money going from place to place as areas peaked in the early days of COVID. Private hospitals in particular are never going to be particularly amenable to keeping the kind of slack that would be required to handle a pandemic. They barely keep enough staff for normal operations.