The darker side of being a doctor

(speaking from US): The reality is we need more doctors. A lot more.

There's no solution other than training a lot, lot, lot, lot more doctors.

Their salaries need to be lower, training needs to be cheaper and faster, and we need a lot more of them.

I see a lot of comments that we need more doctors to be able to pay doctors less. There are of course exceptions but I really don't think 300k a year is unreasonable when coming out with nearly 600k in debt in a field with such high burn out and liability risk.

Unlike salary position that 300k, at least in my field, is all via private equity and we are all independent contractors--meaning does not include any vacation, any paid time off, any sick days, any retirement or medical care or insurance of any kind.

I have not seen a raise since I started which was prior to covid. I'm not saying I need a raise I am well paid but again to be 500k in debt with zero benefits and I see on Reddit buckees managers or UPS /fed ex drivers making 150 to 200k with benefits and the ability to call out sick and the ability to not lose everything because of a single case where you follow standard practices or guidelines followed around the country but something bad still happens.

I go to work everyday with the understanding that the majority of my colleagues have been sued and even if not career ending the stress is enormous. At work I wear a tracker so that every fart and cough and patent interaction can be tracked. A VIP club of patients that donates to the hospital can ruin me with some bad reviews. A stray comment about poor care by an ems crew can end my career (as they bring the hospitals patients).

I don't believe doctors are overpaid and we need more to bring their pay down. A patient will get billed 2000 dollars if they ask for a burrito out front in triage, walk in, are told by me that Taco Bell is across the street, and they promptly walk out without a single test done.

On the other hand I may see sixty people in a busy night which require procedures such as being intubated and put on a ventilator, fractures being reduced , etc.

A major problem is private equity in medicine. Everyone should be focused on removing these groups which skim money off everyone both doctors and patients included. Even if the argument that somehow their efficiency increases result in extra money to the system they can feed on there is no reason why hospitals can't group up and also be efficient and cut them out and pass down savings to the customer or not overwork us docs or treat us like expendable McDonald's employees. The lack of working directly for the hospital there is no metric for skill or seniority or anything like that you are an expendible piece of meat/fall guy that they load down with as many mid level providers as they can get away with

I thought the point of this article is that unsuitable technology and the associated loss of personal agency is seriously affecting the mental health of doctors, yet none of the comments here seem to reflect that.

I remember some friends working in intensive care during the pandemic, I'll never forget their facial expressions after these 24hr shifts... I really wish someone would come up with a better way to do this

Healthcare is the last industry that should be privatized. It should be for the public good rather than for the profit of few.

Important context that's not obvious from the article - this is about the Australian healthcare system. I'd assumed it was the USA.

This very much points to the administrative side causing the damage. The overall toolset is broken and nobody is fixing.

In the same vein: there’s the fantastic book

This is Going to Hurt: Secret Diaries of a Junior Doctor by Adam Kay

Are these problems consistent all over the world, or are they particularly severe in certain countries? I assume there are many studies of this already so it would be good to understand whether this is a problem that has a solution.

Feels like a hundred years later we're still cursed by the cocaine addiction of Dr. William Stewart Halsted

Friends in medicine often mention the constant emotional drain from dealing with suffering and death. Takes a serious toll.

I had a patient who tried and failed to use the legal system to extort me. Extremely frivolous.

I'm in the process of leaving the profession.

I don't feel guilty for the patients who will be left behind, they voted for this.

Wow.

> I had worked in a hospital network that covered 4 campuses and drove 500kms a week when covering these sites. I had worked in a hospital where I didn’t get home for days at a time, sleeping overnight in hospital quarters, outpatient clinic benches and in my car.

As a patient, I'd like the person performing surgery on me to be well-rested!

It gets worse:

> I used to be able to arrange the operating list because I know that some operations take longer than others. But now, the bookings office determine that that all my tonsillectomies take 14 minutes because that’s the average time recorded on the computer. The moment I scrub in, the timer starts. The moment I unscrub timer stops. Click. Click. Click. Because the theatre bookings does not take into account the interpreter time, pre-med period or transfer to ICU, the list is running late. The nurse in charge is breathing down my neck to finish on time.

And yet somehow that 14 minute tonsillectomy gets billed at ~$10,000.

This seems to me like a system that has been hyperoptimized in a way that grinds down the participants.

It's ridiculous. We need more doctors.

Makes you wonder if they face similar on-call burnout but with actual life-or-death stakes. Way more intense than a buggy deploy.

It seems there needs to be more doctors to help reduce the insane workload. Must be lots burn out suffered ? by Drs?

I feel like a very similar article could be written by a teacher.

Friends in residency describe it as a grind that breaks people, not just physically but emotionally too. The toll is immense.

>You might ask, why can’t you work less? It’s not as easy as that. If I decide to work less, who is going to cover the hospital? If the hospital aren’t employing other doctors, we can’t allow patients to go uncovered. I accept the fact that I have a duty of care to be on call.

Yes, you can allow patients to go uncovered. This hero mentality is what leads the bosses to not properly staff and the politicians to not properly fund in the first place.

It is not an individual’s responsibility to correct a societal failure by hurting themselves.

How the US does scheduling is kind of insane. Doctors like pilots (and truck drivers in Europe) should have clear rules about how long they work with rest periods and so on. Giving people 24h shifts is nonsensical and insane.

A few years back a great doctor working at a local children’s hospital took his own life. News said he’d become despondent over children dying when he couldn’t save them. The whole thing is heartbreaking.

I'm not suicidal and have never been suicidal or thought about suicide. I'm happy and in a good mood every day. If someone is thinking about suicide please reach out to me: [email protected] I'll listen to your issues and concerns and we will find a better solution for you.

"I have lost control of my days. I had worked in a hospital where I was oncall 24/7, 12 days out of 14. I had fortnightly weekends off."

Medicine is ran by a bunch of creepy boards. "ACGME Review Committee for Dermatology." For example gets together and votes on how many Dermatologist we get, fun fact it doesn't go up much.

$They were so kind to add 400 more Dermatologist$ in the past decade to the student pipeline.$ What could the rea$son be?

What I would do if you are a doctor and don't hate humans - ask these boards to let more people in (hopefully Americans, but Americans have an uphill climb getting accepted with the flood of fraud applications from around the world).

Same corporate-greedy shit as everywhere but harder, because it's dealing with suffering and death.

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