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Comment by peschu | Hacker News Reader

The picture you are painting is way too dark. And does not give a realistic picture.

A lot of what you say is true for doctors in their first 5-10 years into their career, when employed in a hospital.

This not true for doctors which reached a certain level like „oberarzt“ and above.

This is especially not true for doctors with their own „office“ (business).

Yeah people may cry, but normally it is very hard to bring a doctor to justice even when there are quite obvious mistakes or misconduct. They are very well protected, suing a doctor not seldom takes 10 years from start to verdict, with a lot of legal costs involved.

And last but not least, it is a very secure profession. You must be really really stupid to end up jobless. So you have 5-10 years with a „ok“ salary compared to the power you invest. And 20-30 Years with a very good to exceptional salary, especially when compared to the broader population.

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Surgeon here, in private practice. Agree with the article - all the stressors he mentions are typical of both residents and staff physicians. The hour crunch for me is better post residency but overall the stress is unchanged. Probably higher after training with the added responsibilities & risks.

My sense is that the field developed in the era of independent/private practice, where the grueling hours worked was justified by high pay and minimal bureaucratic/administrative burden. Add decades of stagnant/falling pay plus death by a thousand administrative cuts and the profession no longer justifies the difficult working conditions as convincingly. Some practices are still good, others terrible. Look at the rate of physician turnover to see which is which.

Oh and the “provider” discussion is worth paying attention to. Your doctor has this calculus worked out - years & energy invested, work environment & income expected, then the only viable option in your city is to be employed by a large hospital system (because hospitals get paid at least double for the same work, outcome is as expected.) But wait there’s more: you are now called “provider” by your large hospital employer who hires 2x NP employees to do the “same” work as you and pay half. Guess what direction the pricing pressure is going. In the future expect few MDs to stay in primary care because the system does not support that path. Specialty training is the future for MDs who invest time, energy, & money to excel in their field.

I’m so glad I’m not alone in noticing this “provider” bs. Peel back the creepy Orwellian doublespeak and all you find is cynical ploy to save money by creating a false equivalence of doctors’ work with non-doctors. The health care industry is just the latest home of the money-grubbing vampire squid of finance. Sickens me.

Not sure how much you are actually in the business here, but almost everything you write is incorrect for literally every single doctor we know (cca 50, variously close, everything from GP to heart/neurosurgeons). You are clearly talking about German part, I talk about French, but still same general rules do apply.

Its trivial to sue a doctor, my wife, on her effin' first night shift in the country here got involved death of a patient and got into court case that took 6 months of court hearings to resolve. Not her fault, wasn't her patient even, but she still had to spent ridiculous amount of time for it outside work to get finally cleared.

Her colleague at this moment is getting sued, almost immediately after situation, for overlooking a cancer, when markers from test twice were non-conclusive (I don't/can't go into details, its a very complex case). Suing is very common here, its just that in case error can't be proved on their side, they have cca decent (and expensive) legal insurance. If they don't, license revocation, life-destroying fines, or even jail are on the table. Cases like this are common. This is very common for GPs with their own practice too, since they see more patients than some specialists.

Also not sure why you degrade other's people mental issues when under semi-constant decades of pressure from all sides. "Yeah people may cry" - this ain't how mental issues and burnout should be acknowledged. Please show some respect they properly deserve, you clearly are an outsider to profession and I sense some envy in between your lines. If its that bad with your life, go and start medicine studies, schools are open for anybody of any age and public schools here are free.

Last part - yes unemployment isn't generally high among doctors willing to work, but ie check canton Geneve now - no new GP licenses are granted (as = 0), and old folks are retiring fast. People are desperate to get a GP, I have colleagues begging me to find somebody via my wife for them, new doctors need to travel 2-3h every day to other cantons to find work, and some are properly desperate. As IT guy, I don't know a single capable colleague who has even similar employment issues, companies are always hiring good seniors, and there are tons of companies needing good IT folks left and right.

> A lot of what you say is true for doctors in their first 5-10 years into their career, when employed in a hospital.

Then it's just semi-official hazing. It's still something that should be fixed.

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