[seadan83]

The grammar of the sentence, as written, would really indicate otherwise. Written in the post: "Scarcity drives demand." (exact quote)

The sub-text is that doctors are slightly corrupt and wish to be payed more, and therefore are incetivized to reduce the total number of doctors.

After reading the travails of what this doctor is going through, that seems like a very callous take, insulting even.

[gopher_space]

It’d be callous and insulting if it was a reasoned position.

[seadan83]

IDK if needs to be reasoned or not. I'm imagining someone making these comments to the author's face after having been read the article. The 'callous' part comes from disregarding everything in the article to go on some great tangent about the AMA and artificial scarcity of doctors.

What's more, it seems that this article has triggered a reflexive anti-union stance, when it's more a hallmark of a place where capitalism does not work well. Why doesn't that hospital have more doctors? Surely, they could have found someone additional if they wanted. The hospital did not have to schedule every surgery as if they all required the average procedure time. The hospital could invest in better IT infrastructure and have software that was not a drag to use. Surely the hospital could have someone help the doctor not make 70+ calls over the course of a shift in addition to everything else they do. This blog post is not about a general scarcity of doctors; there's lots that could be done by the hospital investing in its staff and outcomes without hiring a single additional doctor.

[lazide]

Being a business means they have to optimize for profit (to at least some non trivial degree), or die.

Many hospitals are run by non profit organizations to help reduce this problem. However even they cannot run at a loss overall for long. Bankruptcy doesn’t help anyone actually provide services, after all.

Gov’t has different incentives - but then care is strongly controlled and limited by public policy, for better or worse.

And an organization that is able to optimize to produce more value than they consume (aka is more profitable) can take more risks, expand better, have more capital to invest in training, equipment, etc, be more competitive in who they hire, and have better and more comfortable facilities if they want.

And being a Dr. can be really miserable sometimes, and the training is also really hard and miserable.

Some (surgeons, esp. plastic surgery) optimize for maximum $$ for misery, usually. Others (pediatrics) optimize for maximum ‘feel goods’ for misery, usually. Most others are somewhere in between.

Either way, if they didn’t want/need the money, they’d be going to medicine sans frontiers or working in rural medicine eh?

[seadan83]

Skipping some quibbles,would you agree that some optimizations for profit would lead to business death?

Eg, businesses that cheat and get caught. Businesses that over consume and can no longer produce.Also, that optimization can have the opposite effect. Eg, optimize revenue by showing max ads, with max ads users start to flee. A hospital could optimize for patientoutcomes, and then do better because the patients stay around.

This overall though assumes that free market principles work in healthcare. Those principles tend to assume consumer choice.