[djsumdog]

I remember hearing about sleep deprivation in the medical field before; especially for people who work in the ER or as surgeons. The demand in the US for nurses and doctors is very high, and so are the education costs which can be prohibitive to people getting into medicine.

There's a whole system of failures, from the cost of education to the student loan systems to medical insurance and billing, that has led directly to overworked doctors. Many med students today feel that they can't become GPs because they simply won't make enough to pay back their student loans.

[hx87]

The cost of education isn't a obstacle to people getting into medicine, except indirectly by slowing down the opening of new medical schools or expansion of existing ones--otherwise we'd be seeing lots of open spots in and reduce competition for admission to medical schools, which certainly isn't the case. Moreover, new medical schools with a total of 1000+ seats have opened in the past few years. The real bottleneck is in the number of residency slots, which hasn't changed in 20 years.

[jessriedel]

> The real bottleneck is in the number of residency slots, which hasn't changed in 20 years.

Aren't you just refering to the 20-year freeze on the number of medicare-financed residents? I believe the number of residents is still increasing through other funding. Or is there some other way to square your statement with this?:

> Medical school seniors scored a record number of available first-year slots in this year’s Main Residency Match... Continuing a 4-year growth trend, the number of available post-graduate year 1 (PGY-1) positions rose to 27,860 in 2016, 567 more spots than in 2015, and a record 18,668 U.S. allopathic medical school seniors registered for the match, 221 more than in 2015, according to data from the National Resident Matching Program (NRMP). Family medicine residency programs offered 3,238 positions in 2016, up from 3,195 in the 2015 match. Internal medicine experienced similar increases, with residency programs offering 7,024 positions this year, up from 6,770 positions in 2015.

http://www.mdedge.com/internalmedicinenews/article/107413/pr...

[themantalope]

>Many med students today feel that they can't become GPs because they simply won't make enough to pay back their student loans.

I'm at a private (but good) medical school and this is definitely a problem. My tuition (not including living expenses) is about $50,000 per year. And to be honest, there isn't a huge difference in tuition between most private and public medical schools. I'm from NYS, which does a pretty good job subsidizing its state schools. When I was applying to medical school, the in-state price was around $35,000 per year. However, just over the border in Pennsylvania the price at Pitt (which is public) was around $48,000 per year, for out of state students, and maybe 40 or 42k for in state students.

I went to an in state school for undergrad, and I'm very fortunate to have no debt from that. However, many of my classmates who went to good private undergrad schools (Ivy league etc) will have (a lot) of debt from both undergrad and med school. They literally have no choice - they need to go into a high paying specialty if they ever want to pay their loans off.

[user5994461]

> There's a whole system of failures, from the cost of education to the student loan systems to medical insurance and billing, that has led directly to overworked doctors.

There is a "shortage" of doctors and crazy hours in countries with free education, no student loan system and insurance is ensured by the country for all citizens.

So, no, these issues are not the whole story (which doesn't mean they are not issues).

[devoply]

The issue is that of management. The management profession has taken over hospitals and it runs those according to management practices. Overworked doctors are a result of (bad) management, and nothing else.

[dv_dt]

Except that management in hospitals are often doctors themselves (or influenced by the more senior doctors). One problem is that most doctors have gone through a residency with abusive hours - so it becomes hard to separate tradition from necessity.

http://www.latimes.com/business/la-fi-medical-resident-hours...

[devoply]

http://study.com/hospital_management_career.html

[barry-cotter]

I suggest you talk to some older doctors. If you did you'd discover that these insane schedules of work and training have been standard since before either of your parents were born.