US surgeons are killing themselves at an alarming rate. One decided to speak out

Demand for surgery is inelastic instantaneously. That does mean it’s also induced, i.e. more surgeons will generate more surgeries. Supply and demand will still apply.

Good argument for universal public health care.

It’s absolutely dumb to have number of surgeons trained or number of patients undergoing surgery be a function of supply and demand. Enough surgeons should be trained to attend the population and it should be a normal career with normal working hours and a steady salary like any other.

These are smart people, they do not want it to change. Their income would decrease if more people were trained/brought in. Have a lot of physician friends, it's awful and they complain, but are worried about wages. They do not want to make less.

A big part is the expense of undergrad+med school+low residency wages+most grew up upper-middle class and have big expectations. They're very worried about losing ground wage-wise. which is fair in my opinion...they have a de facto union/guild (like most smart people who earn a wage try to do).

“50 years ago … physicians had rates of narcotic addiction 30 to 100 times higher than the general population, and about 100 doctors a year in the US died by suicide.”

“They are taught, throughout a decade of grueling training, to dissociate themselves from their body’s natural cues, telling them that it is time to rest, eat or urinate.”

I’ve done a lot of long hours before in engineering work. I found that at 13 hours I am significantly impaired.

I’ve done 16-24hr days and caffeine stops working the same way around 16 hours. Ephedrine can get you some more time or the adrenaline of a stressful situation.

80-100 hour work weeks for years is crazy for residents. Work is their life. They may not even go home in between shifts. They can do some key drop power naps or navy seal power naps. My cousins are in the field and Maslow’s pyramid is a constant conversation topic.

I’m sure there are some military manuals or doctor support forums you could research further.

“This is going to hurt” is a good window into the field. Book/tv series.

I had similar questions for him just last month. He pointed out that working so much keeps his critical skills really sharp which is what you want when you're doing surgery/emergency.

I suppose when you get woken up to intubate someone, you want it to be second nature rather than a faded skill you practice every couple months because you dropped down to saner hours. But he's also paid hundreds of thousands of dollars to do that.

Fun fact: he said one of the most preventable deaths he sees in the ER is people choking on food alone in their home. I think about that every time I almost choke to death on some gooey cheese. Make sure to chew well, folks.

You get into a weird mental space where you are halfway auto pilot and halfway conscious, and your brain has a really hard time staying focused without being forced to. Hard to explain, but if you’ve been there it makes sense.

Note that this was working, among other places, on nuclear reactors and on flight decks in the US Navy. This is absolutely normal there, and those are fairly dangerous places to be.

I really wish we could place all the blame on the AMA, because I wish it was just a matter of mandating the doubling medical licenses and spots available at medical school/residency and be done with it: something probably thought to be impossible until all the strikes and union walk-outs as of late, particularly in the medical field.

But I've seen this first hand since I was a Bio undergrad: pre-med students were on adderall and ritalin since HS and the things these guys subject themselves to is altogether something else. We were all on 'something' to keep up with the school/work load (it was an impacted major with major cutbacks to the entire departmetn) but their's is even more cut throat and they looked like zombies to super hyper during a lecture--it was jarring as I wanted to just take notes after working a catering shift and coming down myself.

I won't go into hat much detail, because I have been talking about this for nearly a decade to those near and dear to me after some heavy situations with relationships with nurses, but the whole medical system rewards perverse incentives in the US (and later I found in Germany as well, especially after COVID). I went from being convinced med students were really after money and glory to compensate from some shortcomings to eventually feeling incredibly sorry of the incredibly dark form of debt servitude/bondage they subject themselves to for most of their careers. The substance abuse is something that I sincerly hope they speak to those considering go through the process at the HS level, because it has claimed so many lives and ruined so many families in the process.

The opioid crisis made the public aware that substance abuse by physicians was increasing because of how addictive they were, but the drug use/abuse was always there: cocaine, speed, and other SSRIs are common use in residency in order to keep up with the rigorous schedule and demands that come with it.

These people should be venerated for even considering taking the immense burden of dealing with matters of life and death, the fact that we have a system that punishes them for seeking help for mental health issues (revoking medical license) rather than have empathy and compassion should be a real eye opener.

Every medical professional I've known who has or is considering having children has always said they want their children to study art or philosophy instead... that should say it all.

I really felt the weight of this, and the subsequent sadness when I saw what my Orthopedic specialist (surgeon) has gone through before, during and after COVID: I'm genuinely glad her career has taken off, but the candid conversation I had with her back in 2019 when she was unknown makes so sad to see what it cost her.

FYI the government here directly sets the number of spaces available for training doctors, dentists, and veterinarians and still complains that there is a shortage.

Any new addiction (or an untreated old one) or sleep apnea is cause for revocation (or non-issuance) of the medical certificate. You need a medical and a pilot certificate to fly. You can lose the medical temporarily and regain it once the underlying issue is addressed.

Temporary illness or fatigue means you’re supposed to ground yourself voluntarily. That doesn’t happen as often as perhaps it should.

Is the system perfect? Not for physicians nor for pilots.

Everything working, as intended.

45% US Healthcare is paid for by government, already; might as well universalize with the rest of the world's healthcare minimums.