https://www.nytimes.com/2020/03/31/health/hospitals-coronavi...
How do we put a swift end to this nonsense? Surely the public will be overwhelmingly on the side of doctors, nurses and other healthcare workers.
We can't continue to live in this fantasy where companies have so much power over workers and their futures. But changing this involves organizing labor, which is deeply stigmatized in the US.
Hospitals also are fairly well insulated from negative PR as well since they don't operate in a free market, which prevents patients from being able to choose to go elsewhere.
A cynical would say.
The chronic shortage of doctors? Well, that's because they're perhaps the strongest guild. The AMA puts a cap on the supply of doctors (via # of residency slots they allow). The PAs were invented so that another class of workers could do the work of doctors without jeopardizing the doctors' pay or status.
They are not saying that doctors invented PAs to solve the chronic shortage, they're saying that doctors created the chronic shortage which necessitated policy intervention in the form of PAs.
I think you've just misread the comment and would find that it actually agrees strongly with what you said.
This is factually untrue.[1]
It’s worth noting that the AMA also is structured in such a way that gives undue influence to specialist physicians over GPs and ER docs (their representatives essentially get more votes over group policy decisions).
I’d actually argue that physicians haven’t yet fully grasped their power. Historically, many docs worked in independent clinics or small practice groups. That made them subject to antitrust law when teaming up to negotiate en masse against a large insurer, for example.
Today, with all of the consolidation over the past decade, many have become employees. This has made them less powerful in many ways... except, now they can unionize without any of those old antitrust concerns.
USA could do like they do in tech and import already educated people. In tech we welcome that, in medicine that process requires the immigrant doctors to take additional years of study since medical doctors in USA have a post grad degree for no good reason.
I’d argue that Sanders’ lack of success in the polls is due more to voters’ perceived safety in choosing a moderate to beat Trump rather than disapproval of Sanders’ policies. Everyone has become a pundit and believes that the electorate will only tolerate a moderate while many of those same voters voice approval of progressive agenda items like Medicare For All.
Americans are seeing now more than ever just how much they’re valued when our system fails. Unfortunately, it’s going to result in hundreds of thousands and deaths and ruined futures for so many more.
Now why hospitals are demanding that doctors keep quiet about the consequences of emergency operations under extended use protocols? That's an entirely separate issue. Those hospitals should be named and shamed.
But I completely understand restricting PPE to needed areas. The solution to that is to manufacture more PPE. But if we're not going to do that then extended use protocols are just military sense.
What would lead you to believe that "will of the public" commands any agency at all? In a functioning democracy this would be a powerful force but we've had our democracy subverted by decades of corporate interests controlling more of our government at all levels.
The United States is a democracy in name only, it's a useful myth that keeps the public feeling safe but that illusion increasingly seems less useful.
Hospitals are... businesses. They will prioritize their financial success over all else which is to be expected. This sort of press is bad for business, especially long term. They are not concerned with public health, they just happen to house a few people who care about public health.
Fortunately for medicial doctors, they're in such high demand that I don't think any sort of job security is an issue. Iff hospitals and state/federal governments are doing everything they can to obtain PPE (which I believe they are) then I can understand from a public health perspective why you dont want undue stress/panic across the masses (which may result in massive hoarding of PPE for themselves amongst other things), I think it's in the public's interest to know the situation so they may act even more carefully to try to prevent needing to go to hospitals to begin with.
Sometimes knowing about a problem doesn't help much about solving a problem and only causes mental stress--or leads to more problems (mass panic and injuries/fatalities due to this).
I somewhat suspect a lot of this slow rollout of self-isolation process also modeled out public reactions, increased 'escape' travel, hoarding, panicking, etc. and a lot of the rollout dates and gradual release of information of how bad the situation really would be was more planned out than is often suggested. Combined injuries/fatalities due to panic behaviors combined with infection vs slow rollout of isolation. The federal government has access to sophisticated modeling and they typically look at scenarios from a more holistic perspective not just epidemiological related deaths.
When you looked at all the initial data coming from China, we knew this was going to be bad but somehow pretended it wouldn't be and are slowly warming up to accepting the situation. Some of it may just be pure denial, "this cant happen to me" mentalities.
It was pure incompetence that led to the slow rollout.
Unions.
Nice thing about unions, though, is with them it rarely reaches a point like that.
I support emergency whistleblower legislation prohibiting any health care employer (perhaps any employer) from engaging and discrimination or adverse job actions on the basis of an employee's good-faith effort to make a non-negligent report in the public interest of a matter that has previously been reported through internal channels that the employee was aware of and were not overly burdensome.
When every healthcare worker starts defying these types of rules. What are they going to do? Fire all of them?
I agree collective action is the path to long term success, but these workers should not feel a gun is being held to their head by health system administration.
Unfortunately, new entrants to the hospital market are prevented by large state-sponsored moats, and most of the large incumbents are shady in similar ways, so the ability of the staff to choose employer based on ethics/practices is basically meaningless. More options for medical care and medical employment is the answer; the vast majority of people in society are not greedy/shady.
Fix one, and you fix the other. You might also bring prices down, too. (Caveat: it's not "swift", as you requested.)
Not always or completely even. Medical residents and fellows enter a legally binding contract to work at the hospital they match with as part of the application process, and opting to change hospitals during one’s program is nigh impossible.
Ethics/practices vary a lot between countries, and it only takes a small percentage of professionals moving away from one country to a better one to motivate change.