Hacker News Reader

Comment by AngriestLettuce | Hacker News Reader

I don't see how your wife's unreasonable work schedule is supposed to make me feel better about the poor quality of health care I receive. If anything, it makes me question her judgement more, that's just not healthy. How are unhealthy people supposed to educate people on health?

View on HN

It's likely not her choice.

In the UK medical professionals are doing the sensible thing, and leaving the profession. I'm sure most of them would much rather stay, but they're making the rational choice as individuals.

That's not the best choice for patients as a group though.

There's a serious under-staffing, under-pay and conditions crisis.

It's always her choice. And I'm not being flip. Only individuals making good decisions will change this situation. My wife is also a physician and she has thoughtfully opted out of the "rat race." It's good for her, good for her institution, and good for the populations she serves.

So if doctors are intelligent, why do they put up with such a horrible system? Surely they have some sort of power in these scenarios?

They have very little power in most primary care specialties. The expectation from hospitals is you will work this hard or they won’t hire you. Hospitals are more than happy to just dump more hours onto their over-exhausted doctors rather than hire new ones who ask for fewer hours. The expectation from other doctors is you will work this hard because if you don’t, someone else will have to pick up the slack. Also, most of them sign as part of their contract basically “I’ll show up outside of contracted time if it is necessary for patient safety”, turns out this is like 50% of the time because they’re so understaffed

Have they not realized that they can unionize?

Doctors have invested huge sums of time, money, and effort into getting the qualifications needed to perform their jobs, and there are few alternative jobs they can transition into if they are given a bad deal.

I don't mean to be unfair, but this isn't that far from

>If you're so smart why are you poor?

Intelligence has nothing to do with power or leverage in a situation

But it has everything to do with understanding that you can form a union, no?

If you don't even know about these organisations then you're not really qualified to talk about what doctors should or shouldn't be doing or what power they do or don't have.

https://www.bma.org.uk/

https://www.hcsa.com/

https://doctorsinunite.com/

So why haven't those orgs accomplished anything to get better working conditions for doctors?

How do you know they haven't? Just because things aren't perfect doesn't mean things can't be better than they were previously, the NHS has been around for 70 years after all.

Yes, they are striking in the UK.

My point was not at all to make you feel better. It was to explain a systematic reason why doctors underperform and empathize with their position instead of blaming them personally.

To be clear, I was not meaning to blame and sincerely apologize that my comment may have come across that way. Your comment was very helpful in conveying why, ceteris peribus, the perception of doctors may be diminishing. They are too overworked to excel beyond the standard of care, and even consistently meeting the standard of care is a tall order.

But that’s what I was trying to suggest by saying that it seems the medical field, as a whole, seems to be optimizing for the wrong thing, viz. quantity over quality. As others note, there are clearly economic forces at play, and maybe too much constraint on the supply side. And it’s not clear to me that any reasonable discussion is occurring with respect to that. And so I reiterate my pessimism that we’ll somehow get from where we at currently, to a brighter future brought about by a kuhnian revolution as hinted at in the original article. We need to fix what’s broken before adding new features, to put it in software terms.

Reply on news.ycombinator.com