[takinola]

I used to work as a field engineer on oilfields and rigs. We had panels of equipment, each with their own alarms and beeps. Once the rig manager (the client) remarked that we were ignoring the alarms, snidely insinuating that we should pay more attention given the possibility of things going wrong.

The reality was we knew what was going on just by listening to the alarms. I could predict which alarm was going to go off before it did and so I could safely (appear to) ignore them. I would only panic if an unexpected alarm went off (or happened in an unexpected sequence). It is possible the same situation was going on in the hospital.

[KennyBlanken]

Nope. Alarm fatigue is a well documented problem in the medical field.

Like residents who are getting a few hours of sleep over days worth of high-stress / high-stakes work, poor hand-washing between patients, and not clearly printing one's handwriting on prescription forms - all things that kill patients - doctors and hospital administrators just don't care enough.

For a profession that is supposedly so pure morality-wise - do no harm, patient privacy, etc - doctors are remarkably careless.

[hiAndrewQuinn]

"They just didn't care enough" is an argument which can explain everything about how 1 person operates, half of a 10 person group, and roughly 0% of an entire profession. It's a question of the economic incentives at play far more than doctors universally deciding not to give a shit.

The economic recommendation is to deregulate the medical personnel industry and allow supply to increase. A great many smart and good people would love to become doctors but aren't in love with 5 years of residency and taking a quarter million dollars in debt to make less than their dropout cousin does at Netflix.

[nabusman]

Pure deregulation can lead to a bit of anarchy, but a more measured approach that ensures that the regulation doesn't act as a way to decrease supply and increase profits for the industry would make sense. Probably something for Lina Khan to look into.

[nradov]

The easiest way to increase the supply of physicians would be to increase Medicare funding for residency programs. We already have a surplus of smart and good people who would love to become doctors. Every year some of them graduate from medical school with an MD/DO degree but are unable to practice medicine because they don't get matched to a residency slot (some of them do get matched the following year).

https://savegme.org/

There has already been deregulation to an extent. The scope of practice for lower licenses such as Nurse Practitioners and Physician Assistants has been increased in many states such that they are now allowed to perform most primary care services. This is a great option for other smart and good people who don't want to spend 3 - 7+ years in residency and take on enormous student loans.

[matheusmoreira]

> deregulate the medical personnel industry and allow supply to increase

And salaries to plummet.

Who's gonna be the first to volunteer to spend about 14 hours of their day in some shithole hospital nearly every day sacrificing their own health and sanity for the sake of others, all while making a fraction of what people here make? Deny people their prosperity and suddenly going to medical school turns into a stupid and irrational decision and something only rich people will put up with for the status.

[hiAndrewQuinn]

Plummeting salaries for doctors means better average healthcare at all price points for the rest of us.

Plus, play the tape forward. You're working 14 hour days and your pay has been halved in the last 5 years. What can you negotiate on? More pay probably isn't an option. How about working only 12 hour days for 6/7s the (already reduced) pay? That might be doable. In a decade, you might even be working a normal 9 to 5 again. The horror!

[matheusmoreira]

Negotiate? Just quit. At some point you're better off doing literally anything else with your limited time on this earth. Way too much time and effort for too little reward. Who's looking forward to doing a decade of hard training only to end up with some 9-5 job and salary? That's just absolute nonsense.

Becoming a doctor is quite simply a stupid decision if you're not gonna get rich off it. You're replying to a citizen of a country which implemented your idea and then some. Believe it when I say the "get into medical school and you're set for life" meme has worn off.

You haven't seen the damage that stupid indebted underpaid doctors are capable of causing. I'm actually afraid of getting sick. Killing patients? I've seen worse.

[hiAndrewQuinn]

Your profile indicates this is Brasil... Let me do a quick Google search.

"[T]he Brazilian healthcare system has achieved significant success in improving population coverage, reducing infant mortality rates [a 4-fold drop!], and controlling infectious diseases." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10231901/

It sounds like doctors are actually doing a much better job there nowadays than they were 35 years ago. The facts I see simply don't match your outrage.

[LorenPechtel]

Alarm fatigue is very real. And the lack of sleep is very real.

Where you go off the rails is with saying "don't care enough". This is a market problem, not a problem with individuals. "We don't overwork our people" isn't a selling point with insurance. The budget is pretty much fixed, a company that doesn't overwork their people ends up in the red.