[esoleyman]

Are you seriously asking residents to subsidize their own training working 60-80 hours a week [1] and being paid maybe $20-25/hr for 3-7 years while the hospitals make money from their services?

If that were the case, then the only ones who would put up with such a system would be those who have rich families to back them up.

I came from a blue collar background and my family could not help subsidize my training and I could not afford to live, make rent, or afford food if I had to pay for my training as well.

There are so many other things that you are completely glossing over including annual income between generalists vs specialists, pediatricians vs non-pediatricians, reimbursement inequality from Medicare (has not kept up with inflation and is ~40% below inflation), Medicaid pays at best 10-15% on the dollar, and so on.

American physicians also work almost teice as many hours as their European counterparts which would increase their incomes.

[1] it’s considerably more because if you report it then the program can be in danger and lose its credentialing

[ElFitz]

> American physicians also work almost teice as many hours as their European counterparts which would increase their incomes.

I’d be curious as to where you got that. I was personally suprised to discover that in Germany, doctors in university hospitals can work up to 80 hours a week.

https://www.sciencedirect.com/science/article/pii/S016885102...

https://www.statista.com/statistics/1385440/physicians-work-...

https://medicalschoolexpert.co.uk/how-many-hours-do-doctors-...

https://www.theguardian.com/society/2019/jan/15/junior-docto...

https://www.france24.com/en/france/20240219-france-s-foreign...

https://www.irdes.fr/EspaceAnglais/Publications/IrdesPublica...

https://facharztjetzt.de/24-7-guardians-unveiling-the-workin...

[bradleyjg]

US doctors are among the richest people in the entire world, have an involuntary unemployment rate that rounds to zero, can live wherever they like without serious impact on pay and yet somehow are also the most oppressed and put upon if you ask them. Go figure it out.

[esoleyman]

It’s inappropriate to link once dissatisfaction with one’s income.

There are multiple reasons why US doctors are unhappy about their profession. I’m not sure where you get being oppressed as being the titular complaint.

I was an engineer before going to medical school and have an outside perspective as well.

I have complaints with medicine as to how it has changed over the last 10 years and not for the best. I have the right to complain to make things better for my patients and my work-life balance. That doesn’t mean that I am oppressed.

[bradleyjg]

You have the right to complain and I have the right to point out that your industry, along with the housing and education industries, has stolen the entire productivity gains of a generation of Americans. I’m not concerned with your work life balance.

[esoleyman]

Your complaint should be directed towards the hospitals, for-profit insurance companies, and others who profit massively on the backs of patients.

My "industry" is only myself as I am beholden to my patients. I work and am paid by each patient who I treat and receive reimbursement by 50% of them at best.

If you don’t care about my work-life balance and lump me in with the rest of the healthcare system, then there’s nothing much to discuss.

[HDThoreaun]

Doctors also massively profit off the back of patients. They make far more and live a far more lavish lifestyle than doctors in other countries. I have multiple doctors in my family, they all work less than 30 hours a week and make more than 300k. And theyre not even in the lucrative specialties. Most are family physicians which Im sure you know is the worst paid doctor.

[Amezarak]

Health care cost disease in the US has little to do with doctor salaries or demand for doctors. Unfortunately, as that would be a relatively easy problem to solve. The data I've seen indicates physician salaries adjusted for inflation are relatively flat or have even declined since the 1970s.

[esoleyman]

You may be right about the work hours. I possibly mis-remembered an article from several years ago when they compared income and work hours.

[Emma_Goldman]

I agree you should be paid properly. But I don't understand why, if the US has a privatised healthcare system, hospitals are not paying to train their own labour?

[bradleyjg]

US hospitals are almost all nominally non-profit. In practice, they are partnerships run for the economic benefit of controlling employees but the scam the tax code by pretending otherwise.

[esoleyman]

They do to a degree but most of the money comes from the government to subsidize costs. I’m not privy to the amount or percentage but they do cry about it when the residency union (CIR) asks for inflation adjusted salary increases.

[tastyfreeze]

> subsidize their own training working 60-80 hours a week [1] and being paid maybe $20-25/hr for 3-7 years while the hospitals make money from their services

That sounds like an apprenticeship. Many other industries do exactly that. Why should doctors be different?

[LunaSea]

Because you don't work 60 to 80 hours a week during an apprenticeship.

[verteu]

But why must medical residency require 60 to 80 hours per week of work? AFAICT, it's because residencies are competitive, because there aren't enough of them, because nobody wants to pay for them. (But you can't make them unpaid, because, by circular logic, they require 60 to 80 hours per week.)

As an outsider, the whole system seems completely bizarre to me.

> [AMA president] Dr. Richard Corlin has called for re-evaluation of the training process, declaring "We need to take a look again at the issue of why the resident is there."

[LunaSea]

They don't but it's the current situation nonetheless because medical students are at the mercy of their resident doctors.

If you don't do it, they will sack you, fail you or you won't find a job there.

[bradleyjg]

It’s at the intersection of the medical cartel and the credential cartel. A giant pile of suck.