10 ms·

US surgeons are killing themselves at an alarming rate. One decided to speak out

114 points by car 3y ago

mighmi 3y ago
> When an 80-hour workweek for residents was first rolled out in New York state in 1989, surgical trainees were exempt Imagine if the US could double its residencies instead of artificially limiting them!
- Melting_Harps 3y ago
  > Imagine if the US could double its residencies instead of artificially limiting them! I really wish we could place all the blame on the AMA, because I wish it was just a matter of mandating the doubling medical licenses and spots available at medical school/residency and be done with it: something probably thought to be impossible until all the strikes and union walk-outs as of late, particularly in the medical field. But I've seen this first hand since I was a Bio undergrad: pre-med students were on adderall and ritalin since HS and the things these guys subject themselves to is altogether something else. We were all on 'something' to keep up with the school/work load (it was an impacted major with major cutbacks to the entire departmetn) but their's is even more cut throat and they looked like zombies to super hyper during a lecture--it was jarring as I wanted to just take notes after working a catering shift and coming down myself. I won't go into hat much detail, because I have been talking about this for nearly a decade to those near and dear to me after some heavy situations with relationships with nurses, but the whole medical system rewards perverse incentives in the US (and later I found in Germany as well, especially after COVID). I went from being convinced med students were really after money and glory to compensate from some shortcomings to eventually feeling incredibly sorry of the incredibly dark form of debt servitude/bondage they subject themselves to for most of their careers. The substance abuse is something that I sincerly hope they speak to those considering go through the process at the HS level, because it has claimed so many lives and ruined so many families in the process. The opioid crisis made the public aware that substance abuse by physicians was increasing because of how addictive they were, but the drug use/abuse was always there: cocaine, speed, and other SSRIs are common use in residency in order to keep up with the rigorous schedule and demands that come with it. These people should be venerated for even considering taking the immense burden of dealing with matters of life and death, the fact that we have a system that punishes them for seeking help for mental health issues (revoking medical license) rather than have empathy and compassion should be a real eye opener. Every medical professional I've known who has or is considering having children has always said they want their children to study art or philosophy instead... that should say it all. I really felt the weight of this, and the subsequent sadness when I saw what my Orthopedic specialist (surgeon) has gone through before, during and after COVID: I'm genuinely glad her career has taken off, but the candid conversation I had with her back in 2019 when she was unknown makes so sad to see what it cost her.
  - pauldenton 3y ago
    It's not just doubling the medical licenses and slots in the system, it's about breaking the grip of "Doctor required to be present" behavior. Meaning more work in the hands of nurses, ultrasound technicians and other medical staff that aren't doctors but are working in the hospital.
    - colonelpopcorn 3y ago
      That would require the dismantling or restructuring of malpractice law and litigation. The reason a doctor is required to be present is so that an individual can be held responsible to their Hippocratic oath when patients get litigious. Non-board certified staff, AFAIK, don't need to take a Hippocratic oath nor do they need to carry the burden of insurance the same way a doctor or nurse practitioner does.
      - ImPostingOnHN 3y ago
        Many doctors don't actually take the hippocratic oath (some make up their own, like wedding vows) and it wouldn't carry any actual legal force, either. It's like the american pledge of allegiance.
    - ProllyInfamous 3y ago
      I think this is the partial reason, over the past decade, many programs have changes from "Masters"-level to "Doctorate"-level (e.g. NP, PT).
  - ethanbond 3y ago
    All of the intensity leading up to and through med school is also generated by the artificially competitive residency system. Pretty obvious. Med students are not born leagues more competitive than people who go into other high-performing industries. Edit: I said here “all” the intensity is due to this, which isn’t fair. It’s a lucrative job with lots of necessary education so it’ll be both difficult and competitive regardless. The “extraordinary” features of the medical track compared to any other lucrative field, starting from high school onward though, is generated by the residency bottleneck.
- Am4TIfIsER0ppos 3y ago
  Americans keep telling me that their medical system is grossly unregulated so how can that be? FYI the government here directly sets the number of spaces available for training doctors, dentists, and veterinarians and still complains that there is a shortage.
  - jostylr 3y ago
    The medical system is not grossly unregulated. It is not centrally regulated in DC though there is a lot of regulation from there. It is states and localities that regulate it. For example, in some places, a medical professional can add an MRI without much more permission than safety concerns. But in most places, it needs to be negotiated with the various hospital systems, etc. This obviously drives costs up. Ambulance companies need to get permission from other ambulance companies to add an ambulance. These are just a couple of the examples I have come across, but I am sure there are many other examples. Government in the US pays 60% of the medical costs in the US. State licensing applies to all levels of healthcare, not just doctors. Doing minor in home care requires some kind of nursing credential with a supervising doctor-type. The common experience of patients is that they are interacting with private health systems and insurance companies. These systems are grotesquely obscure with prices and it feels like one is being fed to the wolves of capitalism unlike in almost any other market experience in the US. This makes it feel like it is unregulated. But, of course, this can only happen because the government has, by force of law and gun, created a medical cartel, limiting options, prices, and divergent practices.
  - jpadkins 3y ago
    The AMA, a professional guild (and convicted monopolists), set the residency cap in the USA, not the government.
    - EvanAnderson 3y ago
      To be accurate the US Congress set the cap. The AMA lobbied for it.
  - nsvd 3y ago
    Some would say it's over-regulated. In either case, there is certainly a large amount of unhealthy regulatory capture that benefits private companies.
nairboon 3y ago
> .. it cut into the 100-hour-plus weeks that were often the norm for surgical trainees. Serious question: how are these surgeons still awake after one month without resorting to stimulants and other medications? That would be 20h a day, with weekends, or 14h+ a day, every day with no break. If you drive more than about 9h in one go, at least around here, you're considered a threat for others on the street and unfit to drive. But US surgeons are considered high quality after working 14h?
- firstplacelast 3y ago
  As far as I am aware, it is time at the hospital. So they can sleep a bit, but it is not much. These are smart people, they do not want it to change. Their income would decrease if more people were trained/brought in. Have a lot of physician friends, it's awful and they complain, but are worried about wages. They do not want to make less. A big part is the expense of undergrad+med school+low residency wages+most grew up upper-middle class and have big expectations. They're very worried about losing ground wage-wise. which is fair in my opinion...they have a de facto union/guild (like most smart people who earn a wage try to do).
  - ToucanLoucan 3y ago
    > These are smart people, they do not want it to change. Somewhat undercut by the rampant suicide rate. > A big part is the expense of undergrad+med school+low residency wages+most grew up upper-middle class and have big expectations. Oh so when you say "they don't want things to change" what you mean is "they know the path to success and if they try to take care of themselves or demand decent working conditions there's a good chance they'll be fired and end up bankrupt and in a debt trap for life." Got it. That kind of explains the suicides.
  - pcdoodle 3y ago
    Dang, I don't know if I want someone with life work balance skewed in the "sleeping odd hours, suicidal, needing the money" favor poking around in my body.
  - deng 3y ago
sneak 3y ago
> Physician health programs are designed to address the myth that illness automatically means impairment, says Chris Bundy, the executive medical director of the Washington Physicians Health Program and the immediate past president of the national federation that oversees the state programs. An addiction or mental illness may require a physician to take time off, but does not justify an automatic revoking of someone’s license. Imagine if we took this same approach to airline pilots, another job that the performance of which decides whether people live or die. It seems to me that even sleep disturbances should be disqualifying for medical practitioners (and pilots too).
- sokoloff 3y ago
  We do pretty much take that approach with pilots (airline, corporate, and private). Any new addiction (or an untreated old one) or sleep apnea is cause for revocation (or non-issuance) of the medical certificate. You need a medical and a pilot certificate to fly. You can lose the medical temporarily and regain it once the underlying issue is addressed. Temporary illness or fatigue means you’re supposed to ground yourself voluntarily. That doesn’t happen as often as perhaps it should. Is the system perfect? Not for physicians nor for pilots.
  - sneak 3y ago
    My point is that the system for doctors should be more like that for pilots: any substance abuse should render them unfit for practice until the situation changes. It doesn't sound like that is the situation today.
    - cjbprime 3y ago
      I don't see the system for pilots as being praiseworthy. European airlines do not allow pilots to take prescribed antidepressants. It leads to outcomes like a severely psychotic pilot refusing to get appropriate help because they will lose their license and job. These policies are likely the root cause of the 150 deaths on https://en.wikipedia.org/wiki/Germanwings_Flight_9525 https://en.wikipedia.org/wiki/Germanwings_Flight_9525.
eviks 3y ago
> it cut into the 100-hour-plus weeks that were often the norm for surgical trainees. The easy way out is to stop restricting the supply so much, but then the income won't be as stellar, so the top dogs won't be as eager to allow that to happen
- noman-land 3y ago
  What kind of salaries would justify this hell? If you're earning $400k working 100 hour weeks, its the same as earning $160k working 40 hour weeks. That's a totally standard albeit high US software engineer salary.
  - patrick451 3y ago
    Not really. How many software devs do you know who work only 40 hours per week and book at least 160K? How many devs are actually able to hold down 2.5 engineering jobs all pulling in that salary?
- davikr 3y ago
  It is a rational reaction. Those who are already in a field wouldn't react well to suggestions of having a lower wage or unemployment due to a massive expansion of supply or outsourcing. Who would be satisfied with that?
rcarr 3y ago
Supposedly it never used to be this nuts. It mainly came about because of one cokehead surgeon at John Hopkins who got in charge of the training program because of his "increased productivity" and basically started forcing these insane work weeks on everyone. See here: https://en.wikipedia.org/wiki/William_Stewart_Halsted https://en.wikipedia.org/wiki/William_Stewart_Halsted The concluding line of this report[1] is absolutely amazing in that the authors still won't even recognise that he was abusive towards his trainees. After discussing his lifetime coke habit and how his "eager and enthusiastic students" would pick up his slack (e.g that he had conditioned to work ungodly hours for his approval) they write (emphasis mine): *While we are not condemning Halsted*, we are suggesting that if one carefully analyzes and critiques the motivation for the structure of the Halsted surgical residency, his addiction was a major influencing factor. Either way, any person who can pass the entrance exams should be allowed to train as a doctor or surgeon. The fact that we have artificial caps on the numbers, yet surgeons are routinely working 100 hour weeks is an absolute joke. Everyone's health suffers - both surgeon and the patient. The "wages will come down" argument is an absolute joke - at the end of the day, if there's one thing people will pay a high price for, it's "to stay alive". And if there's a second thing people will pay for, it's "to not be in pain". [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7828946/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7828946/
- JumpCrisscross 3y ago
  > The "wages will come down" argument is an absolute joke - at the end of the day, if there's one thing people will pay a high price for, it's "to stay alive". And if there's a second thing people will pay for, it's "to not be in pain" Demand for surgery is inelastic instantaneously. That does mean it’s also induced, i.e. more surgeons will generate more surgeries. Supply and demand will still apply.
  - rcarr 3y ago
    Supply and demand will apply, but there's both a massive internal backlog (at least in the UK) as well as a massive backlog internationally. Globally, the population is still growing so the demand for essential medical treatment is only going to increase for the immediately foreseeable future. And that's just essential treatment. Rightly or wrongly, demand for non-essential treatment like cosmetic surgery and probably, as technology marches onwards, performance enhancing surgery is only increasing. For example, if we created enhanced ligaments that perform better than natural ones, it's not a stretch to imagine competitive athletes having surgery to replace them. I don't think wage protection is a valid reason not to be training surgeons who have the aptitude to do it.
karencarits 3y ago
It seems that this is a problem across nations, not only the US. For example, young Norwegian doctors are also protesting against too much work. Last week, the national broadcaster NRK wrote about a physician who committed suicide: https://www.nrk.no/innlandet/xl/lege-maiken-schultz-tok-sitt-eget-liv-_-forte-til-aksjonen-leger-ma-leve-1.16518310 https://www.nrk.no/innlandet/xl/lege-maiken-schultz-tok-sitt...
DonnyV 3y ago
This is what happens under Capitalism. Financializing everything is ruining everything.
- ProllyInfamous 3y ago
  "Privatize profits, socialize losses." Everything working, as intended. 45% US Healthcare is paid for by government, already; might as well universalize with the rest of the world's healthcare minimums.
DanBC 3y ago
Any death by suicide is a tragedy, and whatever the rate is for surgeons it's too high. This is especially true because there are some protective factors for surgeons - high pay, stable employment, and close connections to health care. But it's simply incorrect to say that surgeons, or doctors in general, have high rates of death by suicide. Whenever anyone presents information about suicide it's important to ask what's being counted, how is it being counted, and who is doing the analysis. Here's CDC suicide rates by industry: https://www.cdc.gov/mmwr/volumes/69/wr/mm6903a1.htm https://www.cdc.gov/mmwr/volumes/69/wr/mm6903a1.htm And Male and female suicide rates per 100,000 civilian, noninstitutionalized working persons aged 16-64 years for major industry groups meeting reporting criteria: https://stacks.cdc.gov/view/cdc/84274 https://stacks.cdc.gov/view/cdc/84274 The rate for healthcare is 7.5 per 100,000 population, but that's driven by female nurses (who have a higher rate of death by suicide than doctors). > Compared with rates in the total study population, suicide rates were significantly higher in five major industry groups: 1) Mining, Quarrying, and Oil and Gas Extraction (males); 2) Construction (males); 3) Other Services (e.g., automotive repair) (males); 4) Agriculture, Forestry, Fishing, and Hunting (males); and 5) Transportation and Warehousing (males and females). Rates were also significantly higher in six major occupational groups: 1) Construction and Extraction (males and females); 2) Installation, Maintenance, and Repair (males); 3) Arts, Design, Entertainment, Sports, and Media (males); 4) Transportation and Material Moving (males and females); 5) Protective Service (females); and 6) Healthcare Support (females).

114 points by car 3y ago

> When an 80-hour workweek for residents was first rolled out in New York state in 1989, surgical trainees were exempt Imagine if the US could double its residencies instead of artificially limiting them!

Melting_Harps 3y ago
> Imagine if the US could double its residencies instead of artificially limiting them! I really wish we could place all the blame on the AMA, because I wish it was just a matter of mandating the doubling medical licenses and spots available at medical school/residency and be done with it: something probably thought to be impossible until all the strikes and union walk-outs as of late, particularly in the medical field. But I've seen this first hand since I was a Bio undergrad: pre-med students were on adderall and ritalin since HS and the things these guys subject themselves to is altogether something else. We were all on 'something' to keep up with the school/work load (it was an impacted major with major cutbacks to the entire departmetn) but their's is even more cut throat and they looked like zombies to super hyper during a lecture--it was jarring as I wanted to just take notes after working a catering shift and coming down myself. I won't go into hat much detail, because I have been talking about this for nearly a decade to those near and dear to me after some heavy situations with relationships with nurses, but the whole medical system rewards perverse incentives in the US (and later I found in Germany as well, especially after COVID). I went from being convinced med students were really after money and glory to compensate from some shortcomings to eventually feeling incredibly sorry of the incredibly dark form of debt servitude/bondage they subject themselves to for most of their careers. The substance abuse is something that I sincerly hope they speak to those considering go through the process at the HS level, because it has claimed so many lives and ruined so many families in the process. The opioid crisis made the public aware that substance abuse by physicians was increasing because of how addictive they were, but the drug use/abuse was always there: cocaine, speed, and other SSRIs are common use in residency in order to keep up with the rigorous schedule and demands that come with it. These people should be venerated for even considering taking the immense burden of dealing with matters of life and death, the fact that we have a system that punishes them for seeking help for mental health issues (revoking medical license) rather than have empathy and compassion should be a real eye opener. Every medical professional I've known who has or is considering having children has always said they want their children to study art or philosophy instead... that should say it all. I really felt the weight of this, and the subsequent sadness when I saw what my Orthopedic specialist (surgeon) has gone through before, during and after COVID: I'm genuinely glad her career has taken off, but the candid conversation I had with her back in 2019 when she was unknown makes so sad to see what it cost her.
- pauldenton 3y ago
  It's not just doubling the medical licenses and slots in the system, it's about breaking the grip of "Doctor required to be present" behavior. Meaning more work in the hands of nurses, ultrasound technicians and other medical staff that aren't doctors but are working in the hospital.
  - colonelpopcorn 3y ago
    That would require the dismantling or restructuring of malpractice law and litigation. The reason a doctor is required to be present is so that an individual can be held responsible to their Hippocratic oath when patients get litigious. Non-board certified staff, AFAIK, don't need to take a Hippocratic oath nor do they need to carry the burden of insurance the same way a doctor or nurse practitioner does.
    - ImPostingOnHN 3y ago
      Many doctors don't actually take the hippocratic oath (some make up their own, like wedding vows) and it wouldn't carry any actual legal force, either. It's like the american pledge of allegiance.
  - ProllyInfamous 3y ago
    I think this is the partial reason, over the past decade, many programs have changes from "Masters"-level to "Doctorate"-level (e.g. NP, PT).
- ethanbond 3y ago
  All of the intensity leading up to and through med school is also generated by the artificially competitive residency system. Pretty obvious. Med students are not born leagues more competitive than people who go into other high-performing industries. Edit: I said here “all” the intensity is due to this, which isn’t fair. It’s a lucrative job with lots of necessary education so it’ll be both difficult and competitive regardless. The “extraordinary” features of the medical track compared to any other lucrative field, starting from high school onward though, is generated by the residency bottleneck.
Am4TIfIsER0ppos 3y ago
Americans keep telling me that their medical system is grossly unregulated so how can that be? FYI the government here directly sets the number of spaces available for training doctors, dentists, and veterinarians and still complains that there is a shortage.
- jostylr 3y ago
  The medical system is not grossly unregulated. It is not centrally regulated in DC though there is a lot of regulation from there. It is states and localities that regulate it. For example, in some places, a medical professional can add an MRI without much more permission than safety concerns. But in most places, it needs to be negotiated with the various hospital systems, etc. This obviously drives costs up. Ambulance companies need to get permission from other ambulance companies to add an ambulance. These are just a couple of the examples I have come across, but I am sure there are many other examples. Government in the US pays 60% of the medical costs in the US. State licensing applies to all levels of healthcare, not just doctors. Doing minor in home care requires some kind of nursing credential with a supervising doctor-type. The common experience of patients is that they are interacting with private health systems and insurance companies. These systems are grotesquely obscure with prices and it feels like one is being fed to the wolves of capitalism unlike in almost any other market experience in the US. This makes it feel like it is unregulated. But, of course, this can only happen because the government has, by force of law and gun, created a medical cartel, limiting options, prices, and divergent practices.
- jpadkins 3y ago
  The AMA, a professional guild (and convicted monopolists), set the residency cap in the USA, not the government.
  - EvanAnderson 3y ago
    To be accurate the US Congress set the cap. The AMA lobbied for it.
- nsvd 3y ago
  Some would say it's over-regulated. In either case, there is certainly a large amount of unhealthy regulatory capture that benefits private companies.

nairboon 3y ago

> .. it cut into the 100-hour-plus weeks that were often the norm for surgical trainees. Serious question: how are these surgeons still awake after one month without resorting to stimulants and other medications? That would be 20h a day, with weekends, or 14h+ a day, every day with no break. If you drive more than about 9h in one go, at least around here, you're considered a threat for others on the street and unfit to drive. But US surgeons are considered high quality after working 14h?

firstplacelast 3y ago
As far as I am aware, it is time at the hospital. So they can sleep a bit, but it is not much. These are smart people, they do not want it to change. Their income would decrease if more people were trained/brought in. Have a lot of physician friends, it's awful and they complain, but are worried about wages. They do not want to make less. A big part is the expense of undergrad+med school+low residency wages+most grew up upper-middle class and have big expectations. They're very worried about losing ground wage-wise. which is fair in my opinion...they have a de facto union/guild (like most smart people who earn a wage try to do).
- ToucanLoucan 3y ago
  > These are smart people, they do not want it to change. Somewhat undercut by the rampant suicide rate. > A big part is the expense of undergrad+med school+low residency wages+most grew up upper-middle class and have big expectations. Oh so when you say "they don't want things to change" what you mean is "they know the path to success and if they try to take care of themselves or demand decent working conditions there's a good chance they'll be fired and end up bankrupt and in a debt trap for life." Got it. That kind of explains the suicides.
- pcdoodle 3y ago
  Dang, I don't know if I want someone with life work balance skewed in the "sleeping odd hours, suicidal, needing the money" favor poking around in my body.
- deng 3y ago

sneak 3y ago

> Physician health programs are designed to address the myth that illness automatically means impairment, says Chris Bundy, the executive medical director of the Washington Physicians Health Program and the immediate past president of the national federation that oversees the state programs. An addiction or mental illness may require a physician to take time off, but does not justify an automatic revoking of someone’s license. Imagine if we took this same approach to airline pilots, another job that the performance of which decides whether people live or die. It seems to me that even sleep disturbances should be disqualifying for medical practitioners (and pilots too).

sokoloff 3y ago
We do pretty much take that approach with pilots (airline, corporate, and private). Any new addiction (or an untreated old one) or sleep apnea is cause for revocation (or non-issuance) of the medical certificate. You need a medical and a pilot certificate to fly. You can lose the medical temporarily and regain it once the underlying issue is addressed. Temporary illness or fatigue means you’re supposed to ground yourself voluntarily. That doesn’t happen as often as perhaps it should. Is the system perfect? Not for physicians nor for pilots.
- sneak 3y ago
  My point is that the system for doctors should be more like that for pilots: any substance abuse should render them unfit for practice until the situation changes. It doesn't sound like that is the situation today.
  - cjbprime 3y ago
    I don't see the system for pilots as being praiseworthy. European airlines do not allow pilots to take prescribed antidepressants. It leads to outcomes like a severely psychotic pilot refusing to get appropriate help because they will lose their license and job. These policies are likely the root cause of the 150 deaths on https://en.wikipedia.org/wiki/Germanwings_Flight_9525 https://en.wikipedia.org/wiki/Germanwings_Flight_9525.

eviks 3y ago

> it cut into the 100-hour-plus weeks that were often the norm for surgical trainees. The easy way out is to stop restricting the supply so much, but then the income won't be as stellar, so the top dogs won't be as eager to allow that to happen

noman-land 3y ago
What kind of salaries would justify this hell? If you're earning $400k working 100 hour weeks, its the same as earning $160k working 40 hour weeks. That's a totally standard albeit high US software engineer salary.
- patrick451 3y ago
  Not really. How many software devs do you know who work only 40 hours per week and book at least 160K? How many devs are actually able to hold down 2.5 engineering jobs all pulling in that salary?
davikr 3y ago
It is a rational reaction. Those who are already in a field wouldn't react well to suggestions of having a lower wage or unemployment due to a massive expansion of supply or outsourcing. Who would be satisfied with that?

rcarr 3y ago

Supposedly it never used to be this nuts. It mainly came about because of one cokehead surgeon at John Hopkins who got in charge of the training program because of his "increased productivity" and basically started forcing these insane work weeks on everyone. See here: https://en.wikipedia.org/wiki/William_Stewart_Halsted https://en.wikipedia.org/wiki/William_Stewart_Halsted The concluding line of this report[1] is absolutely amazing in that the authors still won't even recognise that he was abusive towards his trainees. After discussing his lifetime coke habit and how his "eager and enthusiastic students" would pick up his slack (e.g that he had conditioned to work ungodly hours for his approval) they write (emphasis mine): *While we are not condemning Halsted*, we are suggesting that if one carefully analyzes and critiques the motivation for the structure of the Halsted surgical residency, his addiction was a major influencing factor. Either way, any person who can pass the entrance exams should be allowed to train as a doctor or surgeon. The fact that we have artificial caps on the numbers, yet surgeons are routinely working 100 hour weeks is an absolute joke. Everyone's health suffers - both surgeon and the patient. The "wages will come down" argument is an absolute joke - at the end of the day, if there's one thing people will pay a high price for, it's "to stay alive". And if there's a second thing people will pay for, it's "to not be in pain". [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7828946/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7828946/

JumpCrisscross 3y ago
> The "wages will come down" argument is an absolute joke - at the end of the day, if there's one thing people will pay a high price for, it's "to stay alive". And if there's a second thing people will pay for, it's "to not be in pain" Demand for surgery is inelastic instantaneously. That does mean it’s also induced, i.e. more surgeons will generate more surgeries. Supply and demand will still apply.
- rcarr 3y ago
  Supply and demand will apply, but there's both a massive internal backlog (at least in the UK) as well as a massive backlog internationally. Globally, the population is still growing so the demand for essential medical treatment is only going to increase for the immediately foreseeable future. And that's just essential treatment. Rightly or wrongly, demand for non-essential treatment like cosmetic surgery and probably, as technology marches onwards, performance enhancing surgery is only increasing. For example, if we created enhanced ligaments that perform better than natural ones, it's not a stretch to imagine competitive athletes having surgery to replace them. I don't think wage protection is a valid reason not to be training surgeons who have the aptitude to do it.

karencarits 3y ago

It seems that this is a problem across nations, not only the US. For example, young Norwegian doctors are also protesting against too much work. Last week, the national broadcaster NRK wrote about a physician who committed suicide: https://www.nrk.no/innlandet/xl/lege-maiken-schultz-tok-sitt-eget-liv-_-forte-til-aksjonen-leger-ma-leve-1.16518310 https://www.nrk.no/innlandet/xl/lege-maiken-schultz-tok-sitt...

DonnyV 3y ago

This is what happens under Capitalism. Financializing everything is ruining everything.

ProllyInfamous 3y ago
"Privatize profits, socialize losses." Everything working, as intended. 45% US Healthcare is paid for by government, already; might as well universalize with the rest of the world's healthcare minimums.

DanBC 3y ago

Any death by suicide is a tragedy, and whatever the rate is for surgeons it's too high. This is especially true because there are some protective factors for surgeons - high pay, stable employment, and close connections to health care. But it's simply incorrect to say that surgeons, or doctors in general, have high rates of death by suicide. Whenever anyone presents information about suicide it's important to ask what's being counted, how is it being counted, and who is doing the analysis. Here's CDC suicide rates by industry: https://www.cdc.gov/mmwr/volumes/69/wr/mm6903a1.htm https://www.cdc.gov/mmwr/volumes/69/wr/mm6903a1.htm And Male and female suicide rates per 100,000 civilian, noninstitutionalized working persons aged 16-64 years for major industry groups meeting reporting criteria: https://stacks.cdc.gov/view/cdc/84274 https://stacks.cdc.gov/view/cdc/84274 The rate for healthcare is 7.5 per 100,000 population, but that's driven by female nurses (who have a higher rate of death by suicide than doctors). > Compared with rates in the total study population, suicide rates were significantly higher in five major industry groups: 1) Mining, Quarrying, and Oil and Gas Extraction (males); 2) Construction (males); 3) Other Services (e.g., automotive repair) (males); 4) Agriculture, Forestry, Fishing, and Hunting (males); and 5) Transportation and Warehousing (males and females). Rates were also significantly higher in six major occupational groups: 1) Construction and Extraction (males and females); 2) Installation, Maintenance, and Repair (males); 3) Arts, Design, Entertainment, Sports, and Media (males); 4) Transportation and Material Moving (males and females); 5) Protective Service (females); and 6) Healthcare Support (females).