5 ms·

I don't understand why doctors that are entering the field need to be over-staffed and over-worked. I have a cousin who is an Er surgeon and she needs works 3 d

I don't understand why doctors that are entering the field need to be over-staffed and over-worked. I have a cousin who is an Er surgeon and she needs works 3 days a week, but that certainly was not the case when she was starting out. The work culture of the medical profession looks horribly inefficient. What benefit do you get from buying out young doctors?

jstummbillig 3y ago
Discipline. (I am not saying it's worth it. I don't know.)
opinion-is-bad 3y ago
Poor incentives for the existing members of the system that hold power to implement change. They already cap the number of med students to control salaries, perhaps burning out young doctors fulfills the same purpose, while also (temporarily) covering for the lack of doctors available because of the artificial limit?
rr808 3y ago
Some wards with really sick people benefit from having longer shifts as you see the person progress and have fewer shift changes. Ie with 2 people doing 12 hr shifts is better than 3 people doing 8 hours shifts as the doctors and nurses see how a patient is doing and dont have to communicate to next shift. Something like ER where people come and go all day wouldn't benefit from this however.
- jajko 3y ago
  Yes but you really don't want to be treated at the end of that 12-hour shift, quality of service drops down significantly, they are significantly more tired at that point. Doctors are just humans like rest of us, and those shifts are often brutal.
  - game_the0ry 3y ago
    That’s what I am trying to say, sleep deprivation causes people to make mistakes.
- dimal 3y ago
  I’d rather have three well-rested people and an additional shift change than two burned out, exhausted people. People who are exhausted make mistakes. Maybe it would be better to focus on improving internal communication.
  - rr808 3y ago
    Maybe, I think we have to trust the medical people that they know what they're doing. My baby daughter was in incubated in ICU twice with severe Bronchiolitis. It was nice to see the same people look after her for a week rather than a continual stream of people clocking on and off.
    - krisoft 3y ago
      > It was nice to see the same people look after her for a week rather than a continual stream of people clocking on and off. Surely those people were sleeping from time to time during the week, weren't they? That is the "people clocking on and off".
  - GavinMcG 3y ago
    Have you looked at the research regarding which of those two options leads to better patient outcomes?
    - game_the0ry 3y ago
      Have you? I’d love to hear that answer.
      - CydeWeys 3y ago
        I have. Longer shifts with fewer turn-overs results in better patient outcomes.
        game_the0ry 3y ago
        Source?
- elijaht 3y ago
  But why not 3x12hr shifts rather than (what appears to be from outside perspective), 7x12hr shifts?
- zelphirkalt 3y ago
  In reality it would probably be 2 people doing 13h shifts or 3 people doing 9h shifts, in order to have overlap for handovers and because of hygiene rules, that do not let you walk right in.
nitwit005 3y ago
Personal suspicion is a big part of it is just the people with power generally being fairly old, and not particularly caring about young adults generally. They make the hospitals follow plenty of rules, but let them ignore labor laws in this case.
shufflerofrocks 3y ago
One thing is that the rigid terrific schedule of the modern-day residency program was designed by a cocaine addict who made the structure to fuel and hide his addiction, so all doctors start out with a skewed sense of normal working hours. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7828946/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7828946/) Another thing is the toxic culture perpetuated for allowing medicos to stroke their egos - toxic cultures about overtime are everywhere, but medical profession is a class apart.
- game_the0ry 3y ago
  I remember hearing this story on the Joe Rogan podcast. I was so astonished, I could not believe it until I looked it up myself.
- rtaylorgarlock 3y ago
  Further worthy to note the culture inside surgery departments and residency programs, which seems to feed on exactly this sort of toxicity to measure the worthiness of applicants / residents / graduates. Young surgeon hopefuls should seriously consider the residency process before committing to the field; one of my wife's former co-residents, now early in surgery residency, is surprised by her own fertility challenges, for example. Anyone 'in the business' knows cases like this, and it's a good thing that suicides are national conversation.

jstummbillig 3y ago

Discipline. (I am not saying it's worth it. I don't know.)

opinion-is-bad 3y ago

Poor incentives for the existing members of the system that hold power to implement change. They already cap the number of med students to control salaries, perhaps burning out young doctors fulfills the same purpose, while also (temporarily) covering for the lack of doctors available because of the artificial limit?

rr808 3y ago

Some wards with really sick people benefit from having longer shifts as you see the person progress and have fewer shift changes. Ie with 2 people doing 12 hr shifts is better than 3 people doing 8 hours shifts as the doctors and nurses see how a patient is doing and dont have to communicate to next shift. Something like ER where people come and go all day wouldn't benefit from this however.

jajko 3y ago
Yes but you really don't want to be treated at the end of that 12-hour shift, quality of service drops down significantly, they are significantly more tired at that point. Doctors are just humans like rest of us, and those shifts are often brutal.
- game_the0ry 3y ago
  That’s what I am trying to say, sleep deprivation causes people to make mistakes.
dimal 3y ago
I’d rather have three well-rested people and an additional shift change than two burned out, exhausted people. People who are exhausted make mistakes. Maybe it would be better to focus on improving internal communication.
- rr808 3y ago
  Maybe, I think we have to trust the medical people that they know what they're doing. My baby daughter was in incubated in ICU twice with severe Bronchiolitis. It was nice to see the same people look after her for a week rather than a continual stream of people clocking on and off.
  - krisoft 3y ago
    > It was nice to see the same people look after her for a week rather than a continual stream of people clocking on and off. Surely those people were sleeping from time to time during the week, weren't they? That is the "people clocking on and off".
- GavinMcG 3y ago
  Have you looked at the research regarding which of those two options leads to better patient outcomes?
  - game_the0ry 3y ago
    Have you? I’d love to hear that answer.
    - CydeWeys 3y ago
      I have. Longer shifts with fewer turn-overs results in better patient outcomes.
      - game_the0ry 3y ago
        Source?
elijaht 3y ago
But why not 3x12hr shifts rather than (what appears to be from outside perspective), 7x12hr shifts?
zelphirkalt 3y ago
In reality it would probably be 2 people doing 13h shifts or 3 people doing 9h shifts, in order to have overlap for handovers and because of hygiene rules, that do not let you walk right in.

nitwit005 3y ago

Personal suspicion is a big part of it is just the people with power generally being fairly old, and not particularly caring about young adults generally. They make the hospitals follow plenty of rules, but let them ignore labor laws in this case.

shufflerofrocks 3y ago

One thing is that the rigid terrific schedule of the modern-day residency program was designed by a cocaine addict who made the structure to fuel and hide his addiction, so all doctors start out with a skewed sense of normal working hours. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7828946/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7828946/) Another thing is the toxic culture perpetuated for allowing medicos to stroke their egos - toxic cultures about overtime are everywhere, but medical profession is a class apart.

game_the0ry 3y ago
I remember hearing this story on the Joe Rogan podcast. I was so astonished, I could not believe it until I looked it up myself.
rtaylorgarlock 3y ago
Further worthy to note the culture inside surgery departments and residency programs, which seems to feed on exactly this sort of toxicity to measure the worthiness of applicants / residents / graduates. Young surgeon hopefuls should seriously consider the residency process before committing to the field; one of my wife's former co-residents, now early in surgery residency, is surprised by her own fertility challenges, for example. Anyone 'in the business' knows cases like this, and it's a good thing that suicides are national conversation.