4 ms·

Here is an thought for you: Think of your profession. Count the number of people that are not qualified for the job, or that are actively doing drugs while on

Here is an thought for you: Think of your profession. Count the number of people that are not qualified for the job, or that are actively doing drugs while on the job. Now count how many of those get fired and pushed out of the profession, via judge, customer reviews, bad industry rep, or loss of license. Now doctors. Do you think there are doctors not qualified for the job ? Or on drugs ? Because, there are exactly zero doctors pushed out of the practice of medicine. That should answer a few questions about whether you can implement transparency.

watwut 4y ago
> Because, there are exactly zero doctors pushed out of the practice of medicine. This is exactly not true. You might argue too little doctors are pushed out, but you did not. A doctor loosing ability to practice medicine is an actual real world thing.
- IG_Semmelweiss 4y ago
  Yes, and its so rare that it may be deemed not to exist. Are we arguing about semantics ?
  - ksaun 4y ago
    Opinions may vary, but to me the difference between "so rare that it may be deemed not to exist" and "exactly zero" is not about semantics. (I see "exactly zero" as an absolute statement that therefore precludes such subtleties.)
  - theoldlove 4y ago
    “state medical boards nationwide took away 692 doctors' licenses, or seven per 10,000 physicians, in 2015, the most recent year for which data is available.” https://www.newyorkupstate.com/news/2018/10/new_york_bending_over_backwards_to_let_unfit_docs_keep_medical_licenses.html https://www.newyorkupstate.com/news/2018/10/new_york_bending... Looks like doctors lose their licenses slightly more frequently than lawyers are disbarred
refurb 4y ago
Yup. I used to think "you need to be smart to be a doctor, so all doctors must be really good". Then I worked in an industry that had doctors as customers and wow, no, there are a lot more very bad doctors, a ton of average ones, and only a handful of really, really good ones. The best example was a drug we were basically pulling from the market because a new drug was so much better, we knew it was pointless to keep selling it. For 95%+ doctors, they stayed on top of the latest data and stop using it voluntarily. There were a number of doctor we had to actively visit and tell them "hey, can you stop prescribing our drug? you realize it's practically malpractice considering this new drug is several orders of magnitude better" and they had never heard of the new drug despite it being on the market for over a year. Imagine being one of their patients.
- fallingknife 4y ago
  You need to be good at school to be a doctor. And there's some overlap, but it's definitely not the same thing as being smart.
- AmericanChopper 4y ago
  The selection process for doctors often creates some rather perverse outcomes. Medical schools are hyper competitive, and incredibly demanding. The most typical motives a person might have for enduring those demands are some combination of money, prestige, and the ability to do the rewarding work of helping people. So doctors basically have to be hyper competitive, able to endure incredibly demanding workloads, and could potentially be motivated by some combination or money, prestige and a desire to help people. But there’s no test for the altruistic motives in med school, and competitiveness tends to be more associated with seeking status than altruism, so med schools tends to serve as a selection mechanism for these more shallow personality characteristics. At the very least the common assumption that doctors have an innate passion for serving their patients is not valid. Even if it’s true that most doctors want to help their patients, it’s not necessarily true that their reason for doing so is aligned with the best interests of the patient.
- jasonjayr 4y ago
  In there defense, some of those newer drugs also have an order of magnitude increase in price. I'm sure your point still holds, but some Dr's also consider the patient's ability to afford these treatments as a "Quality of Life" issue too.

watwut 4y ago

> Because, there are exactly zero doctors pushed out of the practice of medicine. This is exactly not true. You might argue too little doctors are pushed out, but you did not. A doctor loosing ability to practice medicine is an actual real world thing.

IG_Semmelweiss 4y ago
Yes, and its so rare that it may be deemed not to exist. Are we arguing about semantics ?
- ksaun 4y ago
  Opinions may vary, but to me the difference between "so rare that it may be deemed not to exist" and "exactly zero" is not about semantics. (I see "exactly zero" as an absolute statement that therefore precludes such subtleties.)
- theoldlove 4y ago
  “state medical boards nationwide took away 692 doctors' licenses, or seven per 10,000 physicians, in 2015, the most recent year for which data is available.” https://www.newyorkupstate.com/news/2018/10/new_york_bending_over_backwards_to_let_unfit_docs_keep_medical_licenses.html https://www.newyorkupstate.com/news/2018/10/new_york_bending... Looks like doctors lose their licenses slightly more frequently than lawyers are disbarred

refurb 4y ago

Yup. I used to think "you need to be smart to be a doctor, so all doctors must be really good". Then I worked in an industry that had doctors as customers and wow, no, there are a lot more very bad doctors, a ton of average ones, and only a handful of really, really good ones. The best example was a drug we were basically pulling from the market because a new drug was so much better, we knew it was pointless to keep selling it. For 95%+ doctors, they stayed on top of the latest data and stop using it voluntarily. There were a number of doctor we had to actively visit and tell them "hey, can you stop prescribing our drug? you realize it's practically malpractice considering this new drug is several orders of magnitude better" and they had never heard of the new drug despite it being on the market for over a year. Imagine being one of their patients.

fallingknife 4y ago
You need to be good at school to be a doctor. And there's some overlap, but it's definitely not the same thing as being smart.
AmericanChopper 4y ago
The selection process for doctors often creates some rather perverse outcomes. Medical schools are hyper competitive, and incredibly demanding. The most typical motives a person might have for enduring those demands are some combination of money, prestige, and the ability to do the rewarding work of helping people. So doctors basically have to be hyper competitive, able to endure incredibly demanding workloads, and could potentially be motivated by some combination or money, prestige and a desire to help people. But there’s no test for the altruistic motives in med school, and competitiveness tends to be more associated with seeking status than altruism, so med schools tends to serve as a selection mechanism for these more shallow personality characteristics. At the very least the common assumption that doctors have an innate passion for serving their patients is not valid. Even if it’s true that most doctors want to help their patients, it’s not necessarily true that their reason for doing so is aligned with the best interests of the patient.
jasonjayr 4y ago
In there defense, some of those newer drugs also have an order of magnitude increase in price. I'm sure your point still holds, but some Dr's also consider the patient's ability to afford these treatments as a "Quality of Life" issue too.