Comments on: The Case against Exhausted Doctors http://timothyblee.com/2009/10/28/the-case-against-exhausted-doctors/ A Blog by Timothy B. Lee Mon, 06 Sep 2010 04:54:54 +0000 hourly 1 http://wordpress.org/?v=abc By: Benny http://timothyblee.com/2009/10/28/the-case-against-exhausted-doctors/comment-page-1/#comment-10680 Benny Wed, 13 Jan 2010 02:26:37 +0000 http://timothyblee.com/?p=1308#comment-10680 In the days before advanced computing technology, it was true that the doctor coming in on the next shift wouldn't know anything about the patient he was being handed. But these days, we can get past that. If American hospitals would just get up-to-date with electronic filing, doctors could share patients, remain in touch, and update the same database with what they've learned. Doctors would be less likely to accidentally kill patients because they didn't know what drugs the previous doctor gave them, and doctors who did fuck up like that wouldn't have an excuse. In the days before advanced computing technology, it was true that the doctor coming in on the next shift wouldn’t know anything about the patient he was being handed. But these days, we can get past that. If American hospitals would just get up-to-date with electronic filing, doctors could share patients, remain in touch, and update the same database with what they’ve learned. Doctors would be less likely to accidentally kill patients because they didn’t know what drugs the previous doctor gave them, and doctors who did fuck up like that wouldn’t have an excuse.

]]> By: Brian Moore http://timothyblee.com/2009/10/28/the-case-against-exhausted-doctors/comment-page-1/#comment-8841 Brian Moore Wed, 04 Nov 2009 21:53:26 +0000 http://timothyblee.com/?p=1308#comment-8841 http://www.forbes.com/forbes/2009/1116/opinions-medicine-doctors-health-heads-up.html Randomly saw this and thought it was applicable. http://www.forbes.com/forbes/2009/1116/opinions-medicine-doctors-health-heads-up.html

Randomly saw this and thought it was applicable.

]]> By: Brian Moore http://timothyblee.com/2009/10/28/the-case-against-exhausted-doctors/comment-page-1/#comment-8694 Brian Moore Mon, 02 Nov 2009 16:39:49 +0000 http://timothyblee.com/?p=1308#comment-8694 Yeah, unfortunately it's a non-uniform barrier to entry. Many specialties have far less exploitative residencies, which is funnelling doctors towards them. Sadly this means less general practictioners and geriatricians, which we need more, rather than less of. "The reality, I suspect, is that hospitals simply aren’t able or willing to shell out the money for the additional doctors they’d need to hire in order to give their residents sane schedules. " There's also an interesting issue in that medicare/aid reimburse hospitals for each resident they have, but only up to a certain limit. So hiring a resident up until that limit (or forcing one you've already hired to stay) is very profitable, but hiring one beyond that limit may lose you money. Look up GME medicare resident payments, or stuff like this: http://www.allacademic.com/meta/p_mla_apa_research_citation/0/9/3/4/5/p93452_index.html The incentives are completely out of whack, especially when you realize that lots of the limits on those subsidies are designed with the assumption that we have a physician surplus (!!!), and we want to de-incentivize more of them. So, for more than one reason, I am completely in agreement here. :) Yeah, unfortunately it’s a non-uniform barrier to entry. Many specialties have far less exploitative residencies, which is funnelling doctors towards them. Sadly this means less general practictioners and geriatricians, which we need more, rather than less of.

“The reality, I suspect, is that hospitals simply aren’t able or willing to shell out the money for the additional doctors they’d need to hire in order to give their residents sane schedules. ”

There’s also an interesting issue in that medicare/aid reimburse hospitals for each resident they have, but only up to a certain limit. So hiring a resident up until that limit (or forcing one you’ve already hired to stay) is very profitable, but hiring one beyond that limit may lose you money.

Look up GME medicare resident payments, or stuff like this:

http://www.allacademic.com/meta/p_mla_apa_research_citation/0/9/3/4/5/p93452_index.html

The incentives are completely out of whack, especially when you realize that lots of the limits on those subsidies are designed with the assumption that we have a physician surplus (!!!), and we want to de-incentivize more of them.

So, for more than one reason, I am completely in agreement here. :)

]]> By: Sarah http://timothyblee.com/2009/10/28/the-case-against-exhausted-doctors/comment-page-1/#comment-8163 Sarah Wed, 28 Oct 2009 15:13:52 +0000 http://timothyblee.com/?p=1308#comment-8163 It's a barrier to entry. There's less competition for existing doctors because few people want to suffer through a residency. It’s a barrier to entry. There’s less competition for existing doctors because few people want to suffer through a residency.

]]> By: Rhayader http://timothyblee.com/2009/10/28/the-case-against-exhausted-doctors/comment-page-1/#comment-8153 Rhayader Wed, 28 Oct 2009 13:23:21 +0000 http://timothyblee.com/?p=1308#comment-8153 Yeah that seems to be a self-evident truth. It has certainly become an accepted fact that driving while tired can impair the driver in much the same way as alcohol intoxication. I assume that hospitals don't want their doctors self-medicating with a flask of Jim Beam on the 7a-7p shift. Yeah that seems to be a self-evident truth. It has certainly become an accepted fact that driving while tired can impair the driver in much the same way as alcohol intoxication. I assume that hospitals don’t want their doctors self-medicating with a flask of Jim Beam on the 7a-7p shift.

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