Doctors Without Balance
April 11th, 2008 by Cali & Jody
We’ve already covered how the legal profession is having a serious internal conversation about balance. Now it seems this issue is affecting doctors as well.
The word in the article that really jumped out at us was “sacrifice,” as in “[Australian Medical Association] president Rosanna Capolingua called on senior doctors to rethink their expectations of young medicos, who were not willing to make the same sacrifices for their jobs.”
The sacrifice in question is time. The idea is that if you are willing to give up your time to your job, then you must be a better worker. Those who make the biggest sacrifices (the story cites 120 hours a week!) deserve the biggest rewards in terms of money, title and prestige.
We don’t dispute that becoming good at something takes a lot of time. And it’s true that high performers do make sacrifices in order to achieve their goals. But while we should recognize and appreciate excellence, it’s wrong for us to applaud sacrifice. What really matters is the value that someone delivers. If a doctor (or any other profession) can deliver the goods in 30 hours, then that doesn’t diminish their accomplishment. If someone else wants to put in 120 hours, that’s their choice. But let’s look at what they are contributing, not how long it took to do it.
Besides, do we really want doctors who only live for work? Wouldn’t it be better (for us and for them) to be whole people with full lives?
This is selfish, but before worrying about the doctors I’m worried for myself. Can people who work 120 hours per week take good care of me? Or do they see a green monster with red eyes and blue ears when they look at me?
This is a perfect example of a profession that can not be done any slower or faster than what it currently is. The doctors aren’t there for 120 hours per week because of paperwork and phone calls. They are there because patients are coming in 24 hours a day 7 days a week.
The reason they are paid so much is because its a highly specialized field and it requires the sacrifice of time. If these new medicos don’t want to work 120 hours a week that is perfectly acceptable, in fact, I applaud them for having a life outside of work, but should we really expect them to get paid equally? There is no way they are helping the hospital as much as they could if they were there longer.
This is a hugely complicated issue, because there are so many regulations that govern how hospitals must be staffed (and for good reason, sometimes). U.S. hospitals have had a staffing crisis because of the rules limiting how many hours per week residents can be made to work (down to 80 from “How long can you stay awake, kid?”). In a hospital half the beds in, say, a neurosurgical ICU might be empty not because there aren’t enough patients (far from it) or nurses (although that’s still a problem, too), but because there aren’t enough residents and attending docs to keep patients safe. And in rural areas? Forget it — if you’re the only general surgeon in town, you’re on call 24-7 and that’s no joke. It’s not short-sighted paper pushers making a doctor’s life hard (unless they are primary care or family medicine docs, in which case, yeah, it kind of is the fault of managed care and the reimbursement system).
If someone could figure out a way for hospitals to provide safe care and solve the staffing nightmare, that would really be something. There is a crisis coming in healthcare staffing. Look out.
I would much rather devote that much time to family and friends. Utopian? Yes. But does anyone else see where this is headed? Mindless robots void of any emotion and driven by the falsity of more = more. YIKES!
If someone sucked (to borrow from Cali and Jody) at what he or she does, but specializes in it (the profession not the sucking)…that individual still deserves to be paid well? Ummm….if yes, I ask…what is the motivation now? It seems you will get paid well no matter how “qualified” you are and especially if you are willing to work a katillionbillionseptillionbazillion hours a week!
Yea, that makes perfect sense to me.
Actually, there is a lot about healthcare which can be done differently (eHealth, teleheath, remote disease monitoring, remote robotic surgery, etc.) given the proper infrastructure
http://www.itwire.com/content/view/14857/127
and the less the unnecessary concentration of patients in hospitals the lower the transmission rates of C. difficile and MRSA would seem to be.
Your right Ed. We could definitely change the landscape of medical practice if we embraced new technologies a little better and properly implemented them I might add.
You would have to ask the hospitals or the doctors that work there, but it seems like they are already paid based on their performance. In fact, a hospital might be the ultimate ROWE, with some exceptions. Doctors can’t go out and do whatever they want because if there is a disaster that 20 minute commute could be the difference in saving someones life. I guess I’m really only considering the surgical side of medicine… it would seem that diagnostics could be a little more lenient with their staff.
But as Stella mentioned, hospitals are far under staffed and that is probably the major cause for the long long hours.