[url]https://www.washingtonpost.com/national/health-science/what-ive-learned-from-my-tally-of-757-doctor-suicides/2018/01/12/b0ea9126-eb50-11e7-9f92-10a2203f6c8d_story.html?utm_term=.e59749160826[/url]
[QUOTE]So I started counting dead doctors. I left that memorial service with a list of 10. Today I have 757 suicides on my registry.
And I began writing and speaking about why doctors die by suicide and why it’s so often hushed up.[/QUOTE]
[QUOTE] Physician suicide is a public health crisis. One million Americans lose their doctors to suicide each year.
Many doctors have lost a colleague to suicide. Some have lost up to eight during their career — with no opportunity to grieve.
We lose way more men than women. For every female physician on my suicide registry, there are seven men. Suicide methods vary by region and gender. Women prefer to overdose and men choose firearms. Gunshot wounds prevail out West. Jumping is popular in New York City. In India, doctors have been found hanging from ceiling fans.[/QUOTE]
[QUOTE]Bullying, hazing and sleep deprivation increase suicide risk. Medical training is rampant with deplorable conditions — such as working nonstop for 24 hours or more — that are not permitted in other industries. Physicians report hallucinations, life-threatening seizures, depression and suicide due to sleep deprivation. Fatigued doctors have felt responsible for harming patients. Resident physicians are now “capped” at 28-hour shifts and 80-hour workweeks. If they “violate” work hours (by caring for patients), they can be forced to lie on their time cards or be written up as “inefficient” and sent to a psychiatrist for stimulant medications. Some doctors kill themselves for fear of harming a patient as a result of their extreme sleep deprivation.[/QUOTE]
I recommend giving this a read.
Very depressing and illuminating.
I feel like I should have heard of this years ago, what the fuck
[QUOTE]Bullying, hazing and sleep deprivation increase suicide risk. Medical training is rampant with deplorable conditions — such as working nonstop for 24 hours or more — that are not permitted in other industries. Physicians report hallucinations, life-threatening seizures, depression and suicide due to sleep deprivation.[/QUOTE]
its bad enough that a doctor has to deal with, well, we all know what they deal with, we don't have to go into that.
If I had to deal with that treatment or suffer endless life debt, I'd probably want to die too
[QUOTE]Medical training is rampant with deplorable conditions — such as working nonstop for 24 hours or more — that are not permitted in other industries. Physicians report hallucinations, life-threatening seizures, depression and suicide due to sleep deprivation. Fatigued doctors have felt responsible for harming patients. Resident physicians are now “capped” at 28-hour shifts and 80-hour workweeks. If they “violate” work hours (by caring for patients), they can be forced to lie on their time cards or be written up as “inefficient” and sent to a psychiatrist for stimulant medications. [/QUOTE]
Why are doctors forced to work this long? Are there just not enough? I skimmed the article but I couldn't see what it explained this.
[QUOTE=Raidyr;53054892]Why are doctors forced to work this long? Are there just not enough? I skimmed the article but I couldn't see what it explained this.[/QUOTE]
I hear there is a very serious lack of doctors and nurses, however I'm ignorant of how serious or broad it is
lets be fair though, it's no surprise. There are happier and easier ways to help people.
[QUOTE=J!NX;53054871]I feel like I should have heard of this years ago, what the fuck
its bad enough that a doctor has to deal with, well, we all know what they deal with, we don't have to go into that.
If I had to deal with that treatment or suffer endless life debt, I'd probably want to die too[/QUOTE]
I can more or less confirm that we did have to deal with 24 hour duties, at least once a week during our internship, if we were in one of the main postings like internal medicine, ob-gyn, A&E, and so forth. One example I can personally offer was when I had to assist the duty professors in a 24 hour posting in ob-gyn to deliver seven babies one after the other with no rest. After the last delivery was finished I collapsed onto the little pallet they give you, woke up a few hours later, then left as soon as I woke up after signing out.
As for debt, when I was studying medical school, I paid around 100k plus 15-20k for books and supplies and what not. If I didn't get high marks in the entrance exam, I'd have to buy my way in for another 100k in admission fees. This was in 2007, by the time I'd left college, this had doubled, then tripled in the three years I was working at my first job. For that 100k, if I didn't have parents who could foot the bill, I would be in bankruptcy if I only had my first salary to depend on (only 600 bucks a month for a single shift, and even if I worked two shifts that wouldn't cover the interest.)
[editline]16th January 2018[/editline]
[QUOTE=Raidyr;53054892]Why are doctors forced to work this long? Are there just not enough? I skimmed the article but I couldn't see what it explained this.[/QUOTE]
The accepted ratio of healthcare professionals, according to the health ministry here, is supposed to be 1 doc to every 10,000 guys. But however, we dont produce nearly as many, and in the state that I live in, we're on shortfall by around 1.3 million doctors to the present population, which number only goes up because our numbers drop by attrition too, the old dying, the younger quitting or being struck off the rolls due to incompetence.
a family friend of mine was in med school, his final two years, he'd regularly pull 24 hour shifts at the connected hospital (to the university). he absolutely despised it and it really got him down, because it'd totally fuck your sleep routine up and you'd constantly be fixing it.
he graduated, worked as a doctor for a year, and now he's studying something else as he doesn't want to be a doctor. it's a really stressful job and doctors are absolute champs.
Well I sure hope we can get robot doctors soon
The way medical schools operate require a complete overhaul.
There needs to be a stimulus in applications, and there needs to be a lower entry fee.
Just because someone can afford medical school doesn't necessarily mean they are a good doctor, then there are all the people who would be great doctors but could never afford the costs.
It's almost as if medschools are judging entries not by their potential but by how much money they can throw into the system.
Really is quite disgusting.
As someone who is trying to get into a med school I can confirm that there is a ridiculous amount of loops to jump through
[QUOTE=Makzu;53054980]Well I sure hope we can get robot doctors soon[/QUOTE]
You say that now but what happens when they take over and peel your spine out through your nose?
Joking aside, society isn't ready for that. We need to improve conditions for everyone before we are ready for robot doctors.
[QUOTE=da space core;53055054]As someone who is trying to get into a med school I can confirm that there is a ridiculous amount of loops to jump through[/QUOTE]
I had a good friend who graduated from University of California Irvine with good grades (biomedical engineering, pre-med) , a good MCAT score, multiple internships doing original research, and his name on published papers... And he couldn't get into medical school. Everywhere he applied told him no.
[QUOTE=J!NX;53055058]You say that now but what happens when they take over and peel your spine out through your nose?
Joking aside, society isn't ready for that. We need to improve conditions for everyone before we are ready for robot doctors.[/QUOTE]
I'unno, robot doctors sound like they could improve conditions for everyone - depending upon efficiency.
[QUOTE=Raidyr;53054892]Why are doctors forced to work this long? Are there just not enough? I skimmed the article but I couldn't see what it explained this.[/QUOTE]
Not enough doctors, not enough residency programs to train new doctors, but volume of patients remains high. Also the tradition/culture of medicine - Doctors were always known for working insane hours, hazing/abuse from superiors was the norm, and in many hospitals, abuse continues to be swept under the rug. Seniors find it hard to sympathize with doctors getting burnt out - [I]"I survived residency when I was your age, why can't you??". [/I]You're simply just expected to work these hours and suck up all the negativity.
Bureaucracy has made the job 10x harder - Can't treat patients because the hospital doesn't want to fund this medication, can't operate on this patient because not enough beds, etc. I've read plenty of articles on how doctors would love spending days at the hospital, surgeons would "stay and play" - Nowadays, they just get burnt out from all the paperwork and obstacles they have to deal with. Everybody gets sued out the ass. Gotta document every single thing you do, gotta make sure you don't piss off the patient by saying something they might find unprofessional in the slightest, which might be a little hard when you've been working for 10 hours without food, water, or a chance to empty your bladder. Did I mention hospitals now like to judge a doctor's performance based off of how happy the patient was during their visit? Believe it or not, some people aren't happy when you save their life because they had to wait 4 hours in a chair before being seen. Believe it or not, drug seekers aren't very happy when the doctor tells them they aren't going to give them dilaudid or fentanyl in the emergency room before seeing a pain specialist first.
Want to see someone about your depression, anxiety, suicidal tendencies? Good fucking luck, the whole hospital is going to know about it. Then all your superiors and colleagues are going to think you're weak, or you're not cut out for the job. What happens when you see abuse from the hospital's most esteemed and popular surgeon? You're told to shut up about it. Keep complaining? You get fired. Get fired during your residency program? Good luck getting hired by another hospital to do a 5 year program there when you're known for being [I]crybaby doctor[/I]. Your reputation is worth a whole fucking lot as a doctor - To the point where you're just not allowed to be a human sometimes or you risk ending your career. Who wants to throw away a career where you've spent [I]years[/I] studying hours every day and racked up hundreds of thousands of dollars in student loans?
Look up "emergency medicine hours" or "surgical resident hours" on the student doctor network forum. They literally have days off in their schedules labelled as "Recovery" where they just sit at home napping all day because they're so fucked from the previous few days of work. It's some seriously demanding work - and it's really sad that our health care providers have some of the highest rates of mental illness and suicide.
[editline]15th January 2018[/editline]
[QUOTE=DiBBs27;53055011]The way medical schools operate require a complete overhaul.
There needs to be a stimulus in applications, and there needs to be a lower entry fee.
Just because someone can afford medical school doesn't necessarily mean they are a good doctor, then there are all the people who would be great doctors but could never afford the costs.
It's almost as if medschools are judging entries not by their potential but by how much money they can throw into the system.
Really is quite disgusting.[/QUOTE]
[QUOTE=sgman91;53055075]I had a good friend who graduated from University of California Irvine with good grades (biomedical engineering, pre-med) , a good MCAT score, multiple internships doing original research, and his name on published papers... And he couldn't get into medical school. Everywhere he applied told him no.[/QUOTE]
[URL="https://www.universityaffairs.ca/features/feature-article/medical-school-admissions-process-skewed/"]I believe it[/URL], docs working on admissions for med schools have gone and said that they had so many top-notch applicants but so few intake positions, they didn't know how to choose who gets in and who gets left out. Best advice they could give to some applicants was "Better luck next year", comparing getting into med school to winning a lottery.
My mother, nearing sixty, worked at least 12 hours a day every day for the last year. And, since this is Hungary, she only earns about 1500 dollars
[QUOTE=sgman91;53055075]I had a good friend who graduated from University of California Irvine with good grades (biomedical engineering, pre-med) , a good MCAT score, multiple internships doing original research, and his name on published papers... And he couldn't get into medical school. Everywhere he applied told him no.[/QUOTE]
If you don't cure cancer or something, you cant get into med school, unless you got connections
My fiancée is in med school currently and rocking it. Getting accepted though was an absolute headache though. She did great in college, research, presentations, community outreach, great grades, good MCAT. It took her 3 application cycles to get it. She eventually opted for a D.O. school here that has a focus on rural medicine which is where she wants to practice at when she's done. But for years schools just didn't even send secondaries or if they did there was either absolutely nothing said afterwords or rejections without interviews. It really does feel like the lottery.
She's getting ready to start rotations which, thankfully, are controlled by the school in the sense that they work standard day shifts and aren't worked like Residency doctors are. Residency scares her to death and scares me for her. She's the type of person that has a hard time running on little sleep, and we know that she's going to have to deal with that. She's looking at family med residencies, which aren't as bad, but it will still be rough. The U.S. realllllly needs to look at how med school and after are being handled and reconsider some things. I know everyone wants their doctor to be the best, I mean it's their life and health at stake. But that doctor is human too, and you can only push so hard before you break them.
[QUOTE=DiBBs27;53055011]The way medical schools operate require a complete overhaul.
There needs to be a stimulus in applications, and there needs to be a lower entry fee.
Just because someone can afford medical school doesn't necessarily mean they are a good doctor, then there are all the people who would be great doctors but could never afford the costs.
It's almost as if medschools are judging entries not by their potential but by how much money they can throw into the system.
Really is quite disgusting.[/QUOTE] Kind of seems like the main problem to focus on right now isn't exactly cost.
There just aren't really enough schools around, it's why people with fantastic GPAs, test scores, and extracurriculars can apply to 20 schools and get turned down by all of them. Acceptance rates are always single-digit.
I'm studying medicine, and while I'm I'll be having some long shifts once in a while, from what I've heard mostly everywhere else you really get fucked over, especially when you just get out of medical school. Heard an interview with a US medical student, and while I know there's a lot of debt and stuff, I was surprised at how much he had to move around the US - first from California to New Orleans to get in to medical school at all, and then to some really Northern state to get a required internship; been a while, might remember some stuff wrong, but I'm glad that I really don't risk anything similar here in Denmark. And we have pretty strict limits on how much you can work later, obviously.
A drawback of the last point is how fast you'll build up experience, but I guess there's no such thing as a free lunch.
This bullshit is completely outrageous and it legitimately makes me want to cry even though I am not related to professional medicine.
WHY is everything so fucking retarded in these areas and how did it come to this point? Hazing and work harassment should be criminally punishable, and ruining someone's reputation from overwork should be classified as defamation and also be legally punishable.
People who label others as “weak” for seeking help in conditions that are not made for human beings are being sociopathic and heartless, and arguably behaving in a manner that should not place them in any profession that cares about human beings in the first place.
The amounts of hours are also insane and it should not be legal to force anyone ANYWHERE to work for that long, doctors are not machines and they are not ancient roman slaves.
Judging a doctor's reputation based on the patient's happiness should either be completely reformed or almost nonexistent because there is never anything happy about going to the doctor. You are there to either unfuck a part of your body or to not die, it's not supposed to be "happy" it's supposed to be functional and helpful.
Naturally there also needs to be something done about the quantity of doctors as well. We seem to be experiencing this horrific vicious loop of there being no doctors because no one wants to work in these conditions and these conditions and hours occur because they are not enough doctors.
It’s kind of the same problem that Japan has except on a much smaller scale and even worse. There is being hardworking and then there is being downright dysfunctional.
As someone whose jumping into pre-med after working in the health care field for 5 years as a surgical tech&Assist, it is intimidating. I hope I can get in, I know a lot is riding on how well I can maintain a strong GPA, and get a good MCAT. As well as articulating my 4 years of working in the OR, and deployed as a Surgical Tech/First Assist in ways that will make sense to civilian schools.
Regarding the hazing....
The hazing is very real, even RN, techs and assists in the OR go through some of the hazing rituals culture wise. Being at a teaching hospital some days you have to pick up, and lift up some of the residences and medical students. Sometimes they deserve it. Some people have such large egos and bad habits its the only way they learn some lessons.
There is still a line I think you shouldn't cross that is easily crossed by 50% of providers. Its interesting watching first year residences turn into 2nd and 3rds, than finally chiefs to see how well they're able to let things roll off their back. Its a similar reaction with lifting up techs and new RNs.
Health care is a very brutal place to work in, you have to leave everything at the door, and take nothing back home with you. Nothing. A lot of people struggle with that, it took me 2 years to developed good coping skills, and methods to leave a lot of stuff at work.
[QUOTE=J!NX;53054871]I feel like I should have heard of this years ago, what the fuck
its bad enough that a doctor has to deal with, well, we all know what they deal with, we don't have to go into that.
If I had to deal with that treatment or suffer endless life debt, I'd probably want to die too[/QUOTE]
Whenever I hear "nurses do all the work and doctors get all the money and credit," I think of this.
[QUOTE=genkaz92;53055275]This bullshit is completely outrageous and it legitimately makes me want to cry even though I am not related to professional medicine.
WHY is everything so fucking retarded in these areas and how did it come to this point? Hazing and work harassment should be criminally punishable, and ruining someone's reputation from overwork should be classified as defamation and also be legally punishable.
People who label others as “weak” for seeking help in conditions that are not made for human beings are being sociopathic and heartless, and arguably behaving in a manner that should not place them in any profession that cares about human beings in the first place.
The amounts of hours are also insane and it should not be legal to force anyone ANYWHERE to work for that long, doctors are not machines and they are not ancient roman slaves.
[/QUOTE]
I'll play the devils advocate a little bit here, but the long shift hours are there to reduce the amount of things that can go wrong. Having the same doctor treating the same patient over the day, rather than 3 different doctors, leads to a more streamlined treatment course and better doctor/patient understanding. A doctor that has been observing a patient over the day may also notice things that can aid in treatment that could be missed. When handovers happen, there's always a chance that miscommunication or misunderstandings could cause problems. Limiting that one changeover a day, with an exhausted doctor, versus three changeovers with well rested and possibly under informed doctors. It seems the medical profession has chosen the former rather than the latter.
[QUOTE=The Aussie;53055924]I'll play the devils advocate a little bit here, but the long shift hours are there to reduce the amount of things that can go wrong. Having the same doctor treating the same patient over the day, rather than 3 different doctors, leads to a more streamlined treatment course and better doctor/patient understanding. A doctor that has been observing a patient over the day may also notice things that can aid in treatment that could be missed. When handovers happen, there's always a chance that miscommunication or misunderstandings could cause problems. Limiting that one changeover a day, with an exhausted doctor, versus three changeovers with well rested and possibly under informed doctors. It seems the medical profession has chosen the former rather than the latter.[/QUOTE]
Develop an ultra precise, redundant, and anal system of doctor to doctor communication during a switch that makes it mandatory for the doctors to go over the task at hand five times over until there is absolute certainty that there was no miscommunication. Record every single thing that was even remotely noteworthy in relation to the patient and make the switch doctor read those logs very carefully.
If three doctors are assigned to a patient to split the huge ass shift, it could be possible for a doctor to read notes about a patient that he is not yet with that the other doctor is observing.
Court rooms use those ultra fast typing machines that allow the creation of extremely rapid notes, those could be used to make medical notes as well to save up on time.
Or have a completely separately trained person who is a "patient observer" who is not a full doctor but competent enough to record everything that happens in order to not bother the doctors.
Change in blood pressure? write down the date and time and make it instantly readable to the doctors, change in respiration rate? make a five second note about it, etc.
[QUOTE=The Aussie;53055924]I'll play the devils advocate a little bit here, but the long shift hours are there to reduce the amount of things that can go wrong.[/QUOTE]
I disagree. It's to save money.
Doctors are required to work alongside others in the team, so to say "the change of staff causes more deaths", you will need to explore that more.
But fatigue and non-caring attitudes are more likely to cause death than an earlier switchover.
[video=youtube;hVODv8A5-EM]https://www.youtube.com/watch?v=hVODv8A5-EM[/video]
[highlight](User was banned for this post ("Video Macro" - Asaratha))[/highlight]
[QUOTE=Useful Dave;53055077]I'unno, robot doctors sound like they could improve conditions for everyone - depending upon efficiency.[/QUOTE]
Several test cases have shown that humans prefer other humans for care, not machines. While robots could deliver medication, most people want a human treating and talking with them.
You have to remember that for those who are sick in bed, they can't get up. Sometimes their only social interaction for the day is the doctor and occasional nurse.
We need better pay and reduced tuition costs.
[QUOTE=SunsetTable;53056665]Several test cases have shown that humans prefer other humans for care, not machines. While robots could deliver medication, most people want a human treating and talking with them.
You have to remember that for those who are sick in bed, they can't get up. Sometimes their only social interaction for the day is the doctor and occasional nurse.
We need better pay and reduced tuition costs.[/QUOTE]
I'd rather say that we need a fuck ton more doctors, or at least a system whereby regular joes can deal with the small problems as certified assistants so that full doctors can deal with the more important shit. We have this system going on currently in the villages of our country where they train locals to take care of the less important things at the primary care level, with an expansion of sorts of the system being discussed in government now.
[url]http://nhm.gov.in/communitisation/asha/about-asha.html[/url] for more info
[QUOTE=Zonesylvania;53056669]I'd rather say that we need a fuck ton more doctors, or at least a system whereby regular joes can deal with the small problems as certified assistants so that full doctors can deal with the more important shit. We have this system going on currently in the villages of our country where they train locals to take care of the less important things at the primary care level, with an expansion of sorts of the system being discussed in government now.
[URL]http://nhm.gov.in/communitisation/asha/about-asha.html[/URL] for more info[/QUOTE]
It's interesting, it a lot of poorer communities, like the one I live in, you will see quite a few no insurance clinics that can take care of all the little daily things that might pop up for someone. I actually went to one a couple times because it was close, and the cost was only ~$25 for a visit. The staff was great, and the doctor seemed knowledgeable. I went in with a really sore and scratchy throat, he proscribed me a generic anti-biotic (which cost like $5), and I went home happy. My total cost was $30 for something that an insurer might pay hundreds for with a normal doctor.
[QUOTE=sgman91;53056985]It's interesting, it a lot of poorer communities, like the one I live in, you will see quite a few no insurance clinics that can take care of all the little daily things that might pop up for someone. I actually went to one a couple times because it was close, and the cost was only ~$25 for a visit. The staff was great, and the doctor seemed knowledgeable. I went in with a really sore and scratchy throat, he proscribed me a generic anti-biotic (which cost like $5), and I went home happy. My total cost was $30 [b]for something that an insurer might pay hundreds for with a normal doctor.[/b][/QUOTE]
Holy shit what? :v: Over here 25€ is the standard cost, and it's all reimbursed anyway.
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