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Okay, but the only reason this is the case is because the doctor cartel limits the number of residency slots to keep physicians in demand and well paid. You don't like your hours, but at the same time, you are against increasing supply: you don't want to bring in foreign doctors (doesn't have to be third world, American doctors earn way more than NHS doctors) and you don't want more American doctors because it will eat into your salary. You've painted yourself into a corner here, unless you have a clever idea for demand destruction.
@Throwaway05 says that the doctor cartel limiting the number of residency slots is an urban legend. I'll live it to him/her to provide details.
This is the data he offered to support his claim the last time. I pointed out that Figures 1, 3, and Table 5 might tell a different story to some folks. This time, he apparently didn't use this citation to support his claim; he only picked out the one statistic from it that sounds like it supports his position, preventing others from seeing the rest of the context.
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Partially addressed with this user down thread.
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This is no longer the case (your citation is from 1965) and is a non-sequitur anyway.
If you cut doctor salaries in half and double the number of doctors, you have improved physician lifestyle at the expense of compensation but not changed costs at all.
This is only true if you also cut the hours doctors work.
If you were working 24 hour shifts, weekends, and holidays - and then someone decided to cut your pay in half. Would you keep working period? Probably not. Would you entertain those hours? Zero chance.
Nurses typically work 3 12s or 4 10s and in some cases make six figures and we already have a nursing shortage problem because they don't like the schedule (because clinical work can suck and nights, weekends, and holidays also suck).
I wouldnt work 24 hour shifts in the first place, and I'd be pissed if I found out that a doctor who was seeing me and potentially making huge decisions or recommendations about my health was 23 hours into a shift.
Anyways, average seems to be somewhere in the 50s of hours per week. Increasing the amount of doctors such that they no longer have to work stupid hours seems like a no brainer, I would easily take a ~30% pay cut to go from 55 hours to 40 and not have 24 hour shifts. No idea why doctors wouldnt either.
https://www.statista.com/statistics/1385440/physicians-work-hours-united-states/
Attending physician work life definitely lands more in the 40-60 range "on average." Surgical specalities can still end up in the 60-80 hour range as an adult.
As a resident 60-80 is more common with 80 being the "max" allowed but many places go over that. Neurosurgeons may end up working 100-120 hour weeks more often than not for like seven fucking years.
The devil is in the details though. Most medical jobs require someone to cover weekends, nights, and holidays. How that shakes out is pretty variable but you can be an attending with a relatively normal 60 hour work week.....but a few times a month you work 24s. Maybe you do trauma at a midsized trauma center. If it's Tuesday you actually sleep through the night. If it's Friday you are working 24 hours in a row. That is ass at age 27. At age 55 it is catastrophic.
Um.....about that.
If you go to a university hospital (you should if you have the choice) you WILL be cared for by a resident who hasn't slept in a day. If you get a surgery done the person operating on you might be on hour 28 and gotten 4 hours of sleep the night before that long ass shift.
Edit: these days theres a good number of women in medicine who decide to work part time for a pay cut. It is a thing but given how time consuming and expensive it is to train someone it's usually unwise.
I'm from the UK, where a typical long shift for a doctor is 13 hours, so I cant really tell if this is an exaggeration.
But if this is true, holy shit. That is absolutely outrageous. how can you with a straight face protest that doctors are so desperately committed patient wellbeing, while accepting a 28 hour long surgery shift? There's no other way to describe it - that's dangerous. You, above all, should know what the science tells us about decreasing performance with fatigue. Any airline pilot that accepted a shift even close to that would lose their license.
The 36 hour shifts are an exaggeration (well, more specifically in some specialties it happens in others it doesn't).
24s are the standard.
To briefly summarize residents are called residents because they lived in the hospital, back in the day when that made sense - the social technology existed to support it (everyone had supportive wives who would still be there after and bring them food) and the medical technology was limited (yeah you lived in the hospital but most overnight work was "shit hope he is still alive in the morning), also the inventor of residency was a massive coke head and we didn't figure that out until later.
Now it is a bit more complicated. Bad outcomes happen, see https://en.wikipedia.org/wiki/Libby_Zion_Law
But 24s are often more popular than the alternative. Often the alternative is something like working 16 hours a day 7 days a week. No or less days off. After a 24 you get home between 6am-12pm and get to sleep until the next day. Or run errands while fucked on sleep deprivation.
The problem is that you need 24/7 365 coverage and that's complicated to do and expensive, residents take the burden.
Importantly our regulatory entities have a bunch of research showing that working 24+ hours is better for patients than handing off to a new team. Things get missed. Your drunk (on lack of sleep) doctor is more reliable than a new doctor that doesn't know you.
I work at a hotel which is open 24/7 365. That means we need someone in the front desk at all times. We have three 8-hour shifts, from 7 AM to 3 PM (morning), from 3 PM to 11 PM (afternoon), and from 11 PM to 7 AM (night). That's 3 x 7 = 21 shifts per week. We have a full-time worker for each shift doing 5 shifts a week, for a total of 3 x 5 = 15 shifts. The other 6 shifts get covered by other people as needed (I cover two afternoon shifts and two night shifts, and somebody else covers the remaining two morning shifts; it helps that our company owns two hotels, so the person with only two shifts at my hotel can work more shifts at the other hotel if they want a full workweek, but in principle you could cover this schedule by having four people working 5 shifts each and rotating the extra day among them unless somebody wants to volunteer for the overtime).
Why can't you do something like this? Sounds to me like the fundamental problem is simply that you need more doctors. Double the number of residents and see if anybody still needs to work 24 hours straight.
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Sometimes there's just no other option. An airline can simply delay the flight until a new pilot is available, but you can't always delay a surgery like that, and there might not be any other surgeons available. We have a massive shortage of doctors because of the dumb med school/residency system.
Of course there is another option - you don't put yourself in that position in the first place. you don't bite off more than you can chew, as an institution. and if you fuck up and end up overbooked, then you take the hard choice and start cancelling surgeries. There might not be another airline pilot available, you think that excuse would fly when a pilot crashes an airliner into a mountain because he was exhausted? of course not. So why should it fly when an exhausted surgeon perforates a bowel or misreads a chart?
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The dynamics today are largely the same.
I acknowledge that physician salaries are only a small part of healthcare spending.
However, your opposition to additional doctors seems to obviously conflict with your complaints about working conditions. How can physician working conditions be improved without additional physicians?
Negative, the AMA has spent the last few decades arguing for an expansion of supply not a restriction, nearly ten percent of residency slots are unfilled every year, and alternate funding for residency spots has been a part of the landscape for a long time.
This meme hasn't been accurate for ages but is very pervasive.
Considering the AMA controls accreditation for medical schools, there's no good reason for slots to go unfilled against their will. Let a thousand med schools bloom.
There is also an excess of medical students applying for spots each year (primarily driven by shitty Caribbean schools and foreign applicants). Even a small number U.S. MDs and DOs go unmatched each year.
We have an excess of supply in the form of medical students and residency spots but for both the excess is of insufficient quality.
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