Comment by dzink | Hacker News Reader

Comment by dzink | Hacker News Reader

In Europe a doctor cannot be sued out of their livelihood, but US doctors are open to that after spending most of their youth (and into their 30s) training for the job with miserable work conditions and pay, and at exorbitant personal financial costs. The cost of the ability to sue doctors trickles everywhere through the training process, insurance, daily documentation, increased testing, and decreased training spots. In surgery for example, every resident has to hunt for opportunities to practice each procedure and fill their portfolio of required skills over time. If they don't the opportunities to do that after going into practice are far more limited. Existing doctors also need to maintain skill levels, or lose them - so the flow of cases in each discipline determines how many good practicing doctors you can have in that discipline. If you dilute the talent pool with the same number of annual cases available, you get many many more bad doctors. A Whipple surgery, for example is one of the longest and most complicated procedures in Surgery. Per studies, you don't want to be operated on by a Surgeon who has less than 15 Whipples per year under their belt. The hard part is not increasing the slots, but increasing the quality of training and existing talent pool when you have more people competing to learn from fewer procedures.

A real innovation would be to open US funded and US led medical training centers in developing countries where you expand the healthcare options to the local population. That way more doctors can be trained by the high US standard of care, on more available cases, while more people get better care. If you want to be able to afford that financially, you need waivers on liability for the care provided. Smaller countries with high standards of care are already inverse examples of that - something along the lines of 80% of healthcare professionals trained in Bulgaria leave the country for better pay elsewhere.

the US can't fund their own healthcare i doubt they'll fund it elsewhere. and unfortunately there is rarely appetite for solving healthcare problems that are affecting mainly developing countries.

Residents work 12+ hour days six to thirteen days in a row. Sometimes the days are longer.

After ten hours you’re not learning. You’re existing and enduring.

Right now medical students are applying to 80+ residencies, and even at top schools some are failing to match.

The system is incredibly broken.

12 hrs is nothing. In many places the shifts are 24 hrs. In surgery residency, most only get to scrub in after they've done all of their admin work - so many deliberately push their hours to get more of what they need the most - OR time.

My wife is a family medicine resident and explained to me that she has a 28 hour shift next month

> Residents work 12+ hour days six to thirteen days in a row. Sometimes the days are longer.

... for absolutely no results.

Spend any time on a busy hospital ward, and you'll see overworked residents trying to one up one another in an attempt to impress whoever is in charge. "I've slept the least hours, therefore without me this floor would collapse". It's institutionalized hazing and cargo culting, nothing more.

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