6 ms·

Are you seriously asking residents to subsidize their own training working 60-80 hours a week [1] and being paid maybe $20-25/hr for 3-7 years while the hospita

Are you seriously asking residents to subsidize their own training working 60-80 hours a week [1] and being paid maybe $20-25/hr for 3-7 years while the hospitals make money from their services? If that were the case, then the only ones who would put up with such a system would be those who have rich families to back them up. I came from a blue collar background and my family could not help subsidize my training and I could not afford to live, make rent, or afford food if I had to pay for my training as well. There are so many other things that you are completely glossing over including annual income between generalists vs specialists, pediatricians vs non-pediatricians, reimbursement inequality from Medicare (has not kept up with inflation and is ~40% below inflation), Medicaid pays at best 10-15% on the dollar, and so on. American physicians also work almost teice as many hours as their European counterparts which would increase their incomes. [1] it’s considerably more because if you report it then the program can be in danger and lose its credentialing

tastyfreeze 3y ago
> subsidize their own training working 60-80 hours a week [1] and being paid maybe $20-25/hr for 3-7 years while the hospitals make money from their services That sounds like an apprenticeship. Many other industries do exactly that. Why should doctors be different?
- LunaSea 3y ago
  Because you don't work 60 to 80 hours a week during an apprenticeship.
  - verteu 3y ago
    But why must medical residency require 60 to 80 hours per week of work? AFAICT, it's because residencies are competitive, because there aren't enough of them, because nobody wants to pay for them. (But you can't make them unpaid, because, by circular logic, they require 60 to 80 hours per week.) As an outsider, the whole system seems completely bizarre to me. > [AMA president] Dr. Richard Corlin has called for re-evaluation of the training process, declaring "We need to take a look again at the issue of why the resident is there."
    - LunaSea 3y ago
      They don't but it's the current situation nonetheless because medical students are at the mercy of their resident doctors. If you don't do it, they will sack you, fail you or you won't find a job there.
    - bradleyjg 3y ago
      It’s at the intersection of the medical cartel and the credential cartel. A giant pile of suck.
ElFitz 3y ago
> American physicians also work almost teice as many hours as their European counterparts which would increase their incomes. I’d be curious as to where you got that. I was personally suprised to discover that in Germany, doctors in university hospitals can work up to 80 hours a week. https://www.sciencedirect.com/science/article/pii/S0168851023000568 https://www.sciencedirect.com/science/article/pii/S016885102... https://www.statista.com/statistics/1385440/physicians-work-hours-united-states/ https://www.statista.com/statistics/1385440/physicians-work-... https://medicalschoolexpert.co.uk/how-many-hours-do-doctors-work/ https://medicalschoolexpert.co.uk/how-many-hours-do-doctors-... https://www.theguardian.com/society/2019/jan/15/junior-doctors-working-past-shift-end-nhs-data-england https://www.theguardian.com/society/2019/jan/15/junior-docto... https://www.france24.com/en/france/20240219-france-s-foreign-doctors-suffer-insecurity-as-hospitals-struggle-to-stay-staffed https://www.france24.com/en/france/20240219-france-s-foreign... https://www.irdes.fr/EspaceAnglais/Publications/IrdesPublications/QES144.pdf https://www.irdes.fr/EspaceAnglais/Publications/IrdesPublica... https://facharztjetzt.de/24-7-guardians-unveiling-the-working-times-of-doctors-in-german-hospitals/ https://facharztjetzt.de/24-7-guardians-unveiling-the-workin...
- bradleyjg 3y ago
  US doctors are among the richest people in the entire world, have an involuntary unemployment rate that rounds to zero, can live wherever they like without serious impact on pay and yet somehow are also the most oppressed and put upon if you ask them. Go figure it out.
  - esoleyman 3y ago
    It’s inappropriate to link once dissatisfaction with one’s income. There are multiple reasons why US doctors are unhappy about their profession. I’m not sure where you get being oppressed as being the titular complaint. I was an engineer before going to medical school and have an outside perspective as well. I have complaints with medicine as to how it has changed over the last 10 years and not for the best. I have the right to complain to make things better for my patients and my work-life balance. That doesn’t mean that I am oppressed.
Emma_Goldman 3y ago
I agree you should be paid properly. But I don't understand why, if the US has a privatised healthcare system, hospitals are not paying to train their own labour?
- esoleyman 3y ago
  They do to a degree but most of the money comes from the government to subsidize costs. I’m not privy to the amount or percentage but they do cry about it when the residency union (CIR) asks for inflation adjusted salary increases.
- bradleyjg 3y ago
  US hospitals are almost all nominally non-profit. In practice, they are partnerships run for the economic benefit of controlling employees but the scam the tax code by pretending otherwise.

tastyfreeze 3y ago

> subsidize their own training working 60-80 hours a week [1] and being paid maybe $20-25/hr for 3-7 years while the hospitals make money from their services That sounds like an apprenticeship. Many other industries do exactly that. Why should doctors be different?

LunaSea 3y ago
Because you don't work 60 to 80 hours a week during an apprenticeship.
- verteu 3y ago
  But why must medical residency require 60 to 80 hours per week of work? AFAICT, it's because residencies are competitive, because there aren't enough of them, because nobody wants to pay for them. (But you can't make them unpaid, because, by circular logic, they require 60 to 80 hours per week.) As an outsider, the whole system seems completely bizarre to me. > [AMA president] Dr. Richard Corlin has called for re-evaluation of the training process, declaring "We need to take a look again at the issue of why the resident is there."
  - LunaSea 3y ago
    They don't but it's the current situation nonetheless because medical students are at the mercy of their resident doctors. If you don't do it, they will sack you, fail you or you won't find a job there.
  - bradleyjg 3y ago
    It’s at the intersection of the medical cartel and the credential cartel. A giant pile of suck.

ElFitz 3y ago

> American physicians also work almost teice as many hours as their European counterparts which would increase their incomes. I’d be curious as to where you got that. I was personally suprised to discover that in Germany, doctors in university hospitals can work up to 80 hours a week. https://www.sciencedirect.com/science/article/pii/S0168851023000568 https://www.sciencedirect.com/science/article/pii/S016885102... https://www.statista.com/statistics/1385440/physicians-work-hours-united-states/ https://www.statista.com/statistics/1385440/physicians-work-... https://medicalschoolexpert.co.uk/how-many-hours-do-doctors-work/ https://medicalschoolexpert.co.uk/how-many-hours-do-doctors-... https://www.theguardian.com/society/2019/jan/15/junior-doctors-working-past-shift-end-nhs-data-england https://www.theguardian.com/society/2019/jan/15/junior-docto... https://www.france24.com/en/france/20240219-france-s-foreign-doctors-suffer-insecurity-as-hospitals-struggle-to-stay-staffed https://www.france24.com/en/france/20240219-france-s-foreign... https://www.irdes.fr/EspaceAnglais/Publications/IrdesPublications/QES144.pdf https://www.irdes.fr/EspaceAnglais/Publications/IrdesPublica... https://facharztjetzt.de/24-7-guardians-unveiling-the-working-times-of-doctors-in-german-hospitals/ https://facharztjetzt.de/24-7-guardians-unveiling-the-workin...

bradleyjg 3y ago
US doctors are among the richest people in the entire world, have an involuntary unemployment rate that rounds to zero, can live wherever they like without serious impact on pay and yet somehow are also the most oppressed and put upon if you ask them. Go figure it out.
- esoleyman 3y ago
  It’s inappropriate to link once dissatisfaction with one’s income. There are multiple reasons why US doctors are unhappy about their profession. I’m not sure where you get being oppressed as being the titular complaint. I was an engineer before going to medical school and have an outside perspective as well. I have complaints with medicine as to how it has changed over the last 10 years and not for the best. I have the right to complain to make things better for my patients and my work-life balance. That doesn’t mean that I am oppressed.

Emma_Goldman 3y ago

I agree you should be paid properly. But I don't understand why, if the US has a privatised healthcare system, hospitals are not paying to train their own labour?

esoleyman 3y ago
They do to a degree but most of the money comes from the government to subsidize costs. I’m not privy to the amount or percentage but they do cry about it when the residency union (CIR) asks for inflation adjusted salary increases.
bradleyjg 3y ago
US hospitals are almost all nominally non-profit. In practice, they are partnerships run for the economic benefit of controlling employees but the scam the tax code by pretending otherwise.