4 ms·

I also lived in two of the richest countries with a social medical system My experience is that GPs are over-worked, under paid (given their responsibilities),

I also lived in two of the richest countries with a social medical system My experience is that GPs are over-worked, under paid (given their responsibilities), and can only afford to do shallow diagnostic in the 5-10 minutes they've got per patient. That's explained by a slow but relentless dismantling of any operational margin that existed in the system, whether it's financial, time etc. I'm talking about the situation in France and the UK, not sure where you are, my point is that I agree about the system failing us, there's a lot to be said about what could be done but that's outside my area of expertise. I'm just being a little nicer to the doctors, as there's only so much they can do given the means they're given.

jajko 2y ago
My wife is a doctor (GP, before internal medicine in biggest hospitals), experience with France and Switzerland. What you say is true - they all start as naive optimists who get treated brutally by whole healthcare system first 7-10 years after school, everybody knows it, often illegal from hospitals but good luck suing your employer. Burned out, 60-70 hour work weeks with weekends is the standard, night shifts, a lot of responsibility with little help/oversight. Always 1 oversight away from harming/killing somebody. Many in Switzerland that are Swiss dropped out, foreigners don't have it so easy. Then afterwards they are put into position where they have 30 minutes for patients (in France its ridiculous 15 mins, saving money = worse diagnosis/treatment, no way around it). Don't expect miracles if they see 20 folks like you daily, ideally with very vague problems like chest pain which can be anything from sprained muscle due to bad sleeping position last night to heart attack, while having 10 other comorbidities and taking various medication. Doctors behave as whole system forces them to behave.
- alex_duf 2y ago
  Doctors burning-out is probably the worse red-flag you could have for a health system. It's frightening to think the person diagnosing my parents and children might not be in full possession of their capacity or make rash decisions. I'm seeing the same pattern for many crucial functions having been pushed over the line during the last two decades or so. Whether it's a doctor, a teacher, a nurse, a childminder, the police, etc. All the jobs that are essential for a developed society have crumbled down to the point I'd discourage any young person to pursue a career in that sector.
  - jajko 2y ago
    If that worries you (and it should), never ever go to hospital during night (unless serious emergency of course) or very early morning, or generally just before the end of shifts. You will get potentially worse treatment by definition, depends on many things but probability is against you. Also, the bigger the hospital usually the better experts they have on critical stuff (and more chance you won't wait long for ie CT or MRI), smaller hospitals and clinics just forward serious patients to big ones. At the end healthcare is just another branch of market and all woes that apply to rest of us apply to them, no magical immunity due to more noble profession.
flanked-evergl 2y ago
> My experience is that GPs are over-worked, under paid (given their responsibilities Their work hours are no longer than anyone else, their pay is way above the average, and their liability is as low as possible. > and can only afford to do shallow diagnostic in the 5-10 minutes they've got per patient. My doctor spends it explaining to me how I should just not care that something is wrong and accept that the medical industry is too incompetent to figure out what it is and that there are people who have worse problems, even though he has no idea what is actually wrong.
- capnrefsmmat 2y ago
  The best sources I can find indicate that doctors work ~25% more hours than other workers, on average, though this has declined since the 70s. https://www.ajpmonline.org/article/S0749-3797(23)00166-6/fulltext https://www.ajpmonline.org/article/S0749-3797(23)00166-6/ful... https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2915438/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2915438/
  - flanked-evergl 2y ago
    I don't live in the US so the stat is not really relevant.
- gbuk2013 2y ago
  > Their work hours are no longer than anyone else, their pay is way above the average, and their liability is as low as possible. YMMV but as a software developer I am certainly not going to start throwing stones in a glass house. :) Also consider additional time and cost of a doctor completing their education while working up to a max of 80h per week, which would be illegal for any reasonable profession.
  - flanked-evergl 2y ago
    > Also consider additional time and cost of a doctor completing their education while working up to a max of 80h per week, which would be illegal for any reasonable profession. I'm not sure why the educational requirements are so extreme for all doctors. Certainly for some, like surgeons, I get it, but for my GP I think it's a total farce. I don't make the rules though, I just can see a broken system when it's right in front of me.

jajko 2y ago

My wife is a doctor (GP, before internal medicine in biggest hospitals), experience with France and Switzerland. What you say is true - they all start as naive optimists who get treated brutally by whole healthcare system first 7-10 years after school, everybody knows it, often illegal from hospitals but good luck suing your employer. Burned out, 60-70 hour work weeks with weekends is the standard, night shifts, a lot of responsibility with little help/oversight. Always 1 oversight away from harming/killing somebody. Many in Switzerland that are Swiss dropped out, foreigners don't have it so easy. Then afterwards they are put into position where they have 30 minutes for patients (in France its ridiculous 15 mins, saving money = worse diagnosis/treatment, no way around it). Don't expect miracles if they see 20 folks like you daily, ideally with very vague problems like chest pain which can be anything from sprained muscle due to bad sleeping position last night to heart attack, while having 10 other comorbidities and taking various medication. Doctors behave as whole system forces them to behave.

alex_duf 2y ago
Doctors burning-out is probably the worse red-flag you could have for a health system. It's frightening to think the person diagnosing my parents and children might not be in full possession of their capacity or make rash decisions. I'm seeing the same pattern for many crucial functions having been pushed over the line during the last two decades or so. Whether it's a doctor, a teacher, a nurse, a childminder, the police, etc. All the jobs that are essential for a developed society have crumbled down to the point I'd discourage any young person to pursue a career in that sector.
- jajko 2y ago
  If that worries you (and it should), never ever go to hospital during night (unless serious emergency of course) or very early morning, or generally just before the end of shifts. You will get potentially worse treatment by definition, depends on many things but probability is against you. Also, the bigger the hospital usually the better experts they have on critical stuff (and more chance you won't wait long for ie CT or MRI), smaller hospitals and clinics just forward serious patients to big ones. At the end healthcare is just another branch of market and all woes that apply to rest of us apply to them, no magical immunity due to more noble profession.

flanked-evergl 2y ago

> My experience is that GPs are over-worked, under paid (given their responsibilities Their work hours are no longer than anyone else, their pay is way above the average, and their liability is as low as possible. > and can only afford to do shallow diagnostic in the 5-10 minutes they've got per patient. My doctor spends it explaining to me how I should just not care that something is wrong and accept that the medical industry is too incompetent to figure out what it is and that there are people who have worse problems, even though he has no idea what is actually wrong.

capnrefsmmat 2y ago
The best sources I can find indicate that doctors work ~25% more hours than other workers, on average, though this has declined since the 70s. https://www.ajpmonline.org/article/S0749-3797(23)00166-6/fulltext https://www.ajpmonline.org/article/S0749-3797(23)00166-6/ful... https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2915438/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2915438/
- flanked-evergl 2y ago
  I don't live in the US so the stat is not really relevant.
gbuk2013 2y ago
> Their work hours are no longer than anyone else, their pay is way above the average, and their liability is as low as possible. YMMV but as a software developer I am certainly not going to start throwing stones in a glass house. :) Also consider additional time and cost of a doctor completing their education while working up to a max of 80h per week, which would be illegal for any reasonable profession.
- flanked-evergl 2y ago
  > Also consider additional time and cost of a doctor completing their education while working up to a max of 80h per week, which would be illegal for any reasonable profession. I'm not sure why the educational requirements are so extreme for all doctors. Certainly for some, like surgeons, I get it, but for my GP I think it's a total farce. I don't make the rules though, I just can see a broken system when it's right in front of me.