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Just train more doctors. For some reason the Western hemisphere is extremely resistant to large scale training of healthcare workers. Train doctors like enginee

Just train more doctors. For some reason the Western hemisphere is extremely resistant to large scale training of healthcare workers. Train doctors like engineers and you won't have a shortage of good ones.

ametrau 3y ago
But won’t you have more bad ones? We need better mechanisms to properly deal with incompetent/careless med workers.
- mlyle 3y ago
  You -might- have a slightly higher proportion of “bad ones,” but you would also have a system with less of a capacity shortage. In turn, the harms from lesser practitioners would likely be less, and you could more readily suspend for misconduct. Some of those we consider bad ones might even be considerably better under a little less time pressure.
  - ametrau 3y ago
    Interesting. The harm that a doctor can do is very serious though. Who are the unlucky shlubs who get the bad end of the distribution?
    - mlyle 3y ago
      Not having sufficient care can do some pretty serious harm. It's not like all the new doctors we'll be adding will be worse than the existing set. Taking your argument to the extreme: if we have no doctors, they can't do any harm. Is that best? Or, we could get rid of 20% of doctors and avoid getting rid of the best, which would improve the quality of the distribution. Would that be better?
- matheusmoreira 3y ago
  > But won’t you have more bad ones? You absolutely will. People should be extremely careful what they wish for. Simplistic solutions like "just train more doctors" can and will have disastrous unforeseen consequences.
selimthegrim 3y ago
Are these gonna be like Soviet doctors who didn’t know how to read EKGs?
- matheusmoreira 3y ago
  It's very likely. The "soviet doctor" thing you mentioned is just so amusing to me. I'm brazilian, our current president is a literal communist who fancies himself the creator of a south american soviet union, he has a populist "doctors for the poor" policy which essentially consists of flooding the market with doctors via huge numbers of shitty medical schools that don't even have a hospital for the students to practice in, he's directly quoted as saying things like "we must create a new generation of leftist doctors who accept working for less"... And now there are doctors who do not know how to identify a possible myocardial infarction on an EKG. There are doctors out there who cannot spot an ST segment elevation or depression on an EKG. Hell I've seen one doctor send a patient presenting with classic myocardial infarction symptoms home with pain meds without even running a simple, cheap, fast, non-invasive and universally available EKG. I wish I was making this up, my own goddamn lawyer made an example of this last idiot because obviously the patient died and it's just impossible to defend that conduct. I'm actually afraid of being sick and not having trusted doctors to care for me. But of course my comment above describing this terrible situation was flagged. Welp. People here would be horrified if I described the literal quackery and charlatanism I see in this country on a daily basis. Blow smoke up people's ass tier stuff and I mean that literally. Worst part is those doctors make metric fucktons of money while the good ones are hated because they don't swindle patients with easy solutions that don't actually work.
sarchertech 3y ago
[flagged]
crooked-v 3y ago
A big part of the basic problem in the US is the artificially limited residency system [1], which has gotten so bad that states are now explicitly letting foreign doctors skip residency requirements to work in the US [2]. [1]: https://www.aamc.org/news/medical-school-enrollments-grow-residency-slots-haven-t-kept-pace https://www.aamc.org/news/medical-school-enrollments-grow-re... [2]: https://www.medscape.com/viewarticle/993693 https://www.medscape.com/viewarticle/993693?
matheusmoreira 3y ago
[flagged]
- watwut 3y ago
  And meanwhile we select by willingness to go through basically hazing on top of inteligence. And meanwhile we routinely have doctors to perform in severely sleep deprived state too for no reason at all.
  - matheusmoreira 3y ago
    > on top of intelligence That's enough for a minimum baseline of quality. Medical school in general is hellish enough to drive people to actual suicide and there's plenty that can be said about that but at least stupid people can't get into these schools. It could always be worse. It could be a pointless system that inflicted hell on students and minted shitty doctors!
- sudosysgen 3y ago
  It doesn't take above average intelligence to go through med school, so long as you have high discipline and motivation. Good memory helps the most, really. There is a simple way to know that we could train more doctors - failure rates are very low, which means that either the MCAT is a better filter than the exams (unlikely!), or that it would be possible to train a lot more doctors.
  - sarchertech 3y ago
    The failure rate in all graduate education is low, because you’re only taking people who have already performed well for 4 years in undergrad. For med school specifically, you’re only taking the top performers, then of those you’re filtering further based on MCAT scores. If you’re that selective and you already have a 15-20% failure rate, I’m not sure that lowering the entry requirements is a great use of resources. You don’t really want a 40% failure rate. That’s a lot of wasted time, effort, and money. There are already many alternate career paths for medical practitioners who can’t make it into med school or just don’t want to spend as much time in training.
deleted 3y ago
[deleted]

ametrau 3y ago

But won’t you have more bad ones? We need better mechanisms to properly deal with incompetent/careless med workers.

mlyle 3y ago
You -might- have a slightly higher proportion of “bad ones,” but you would also have a system with less of a capacity shortage. In turn, the harms from lesser practitioners would likely be less, and you could more readily suspend for misconduct. Some of those we consider bad ones might even be considerably better under a little less time pressure.
- ametrau 3y ago
  Interesting. The harm that a doctor can do is very serious though. Who are the unlucky shlubs who get the bad end of the distribution?
  - mlyle 3y ago
    Not having sufficient care can do some pretty serious harm. It's not like all the new doctors we'll be adding will be worse than the existing set. Taking your argument to the extreme: if we have no doctors, they can't do any harm. Is that best? Or, we could get rid of 20% of doctors and avoid getting rid of the best, which would improve the quality of the distribution. Would that be better?
matheusmoreira 3y ago
> But won’t you have more bad ones? You absolutely will. People should be extremely careful what they wish for. Simplistic solutions like "just train more doctors" can and will have disastrous unforeseen consequences.

selimthegrim 3y ago

Are these gonna be like Soviet doctors who didn’t know how to read EKGs?

matheusmoreira 3y ago
It's very likely. The "soviet doctor" thing you mentioned is just so amusing to me. I'm brazilian, our current president is a literal communist who fancies himself the creator of a south american soviet union, he has a populist "doctors for the poor" policy which essentially consists of flooding the market with doctors via huge numbers of shitty medical schools that don't even have a hospital for the students to practice in, he's directly quoted as saying things like "we must create a new generation of leftist doctors who accept working for less"... And now there are doctors who do not know how to identify a possible myocardial infarction on an EKG. There are doctors out there who cannot spot an ST segment elevation or depression on an EKG. Hell I've seen one doctor send a patient presenting with classic myocardial infarction symptoms home with pain meds without even running a simple, cheap, fast, non-invasive and universally available EKG. I wish I was making this up, my own goddamn lawyer made an example of this last idiot because obviously the patient died and it's just impossible to defend that conduct. I'm actually afraid of being sick and not having trusted doctors to care for me. But of course my comment above describing this terrible situation was flagged. Welp. People here would be horrified if I described the literal quackery and charlatanism I see in this country on a daily basis. Blow smoke up people's ass tier stuff and I mean that literally. Worst part is those doctors make metric fucktons of money while the good ones are hated because they don't swindle patients with easy solutions that don't actually work.

sarchertech 3y ago

[flagged]

crooked-v 3y ago

A big part of the basic problem in the US is the artificially limited residency system [1], which has gotten so bad that states are now explicitly letting foreign doctors skip residency requirements to work in the US [2]. [1]: https://www.aamc.org/news/medical-school-enrollments-grow-residency-slots-haven-t-kept-pace https://www.aamc.org/news/medical-school-enrollments-grow-re... [2]: https://www.medscape.com/viewarticle/993693 https://www.medscape.com/viewarticle/993693?

matheusmoreira 3y ago

[flagged]

watwut 3y ago
And meanwhile we select by willingness to go through basically hazing on top of inteligence. And meanwhile we routinely have doctors to perform in severely sleep deprived state too for no reason at all.
- matheusmoreira 3y ago
  > on top of intelligence That's enough for a minimum baseline of quality. Medical school in general is hellish enough to drive people to actual suicide and there's plenty that can be said about that but at least stupid people can't get into these schools. It could always be worse. It could be a pointless system that inflicted hell on students and minted shitty doctors!
sudosysgen 3y ago
It doesn't take above average intelligence to go through med school, so long as you have high discipline and motivation. Good memory helps the most, really. There is a simple way to know that we could train more doctors - failure rates are very low, which means that either the MCAT is a better filter than the exams (unlikely!), or that it would be possible to train a lot more doctors.
- sarchertech 3y ago
  The failure rate in all graduate education is low, because you’re only taking people who have already performed well for 4 years in undergrad. For med school specifically, you’re only taking the top performers, then of those you’re filtering further based on MCAT scores. If you’re that selective and you already have a 15-20% failure rate, I’m not sure that lowering the entry requirements is a great use of resources. You don’t really want a 40% failure rate. That’s a lot of wasted time, effort, and money. There are already many alternate career paths for medical practitioners who can’t make it into med school or just don’t want to spend as much time in training.

deleted 3y ago

[deleted]