Monday, March 07, 2005

Long hours in residency

Megan McArdle has posted twice recently on this subject. Here and Here. The comments were many and interesting and reflected quite a bit of animosity and perhaps some jealousy.

Several comments that I didn't want lost in the shuffle.
  • Many of the comments, and indeed, the main post, discussed the impairment sleep deprivation causes. What wasn't discussed was the possibility that med school and residency are designed to screen for those who could, or screen out those who couldn't, function acceptably well despite this. Perhaps those who couldn't function well in this environment dropped out, or went into medical specialties that didn't require this kind of tolerance. Does anyone out there have any studies about this?
    The comments about Navy Seals touched on this. When I was in the Navy, I knew many Seals, Seal washouts, and saw BUDS students (Seal training) in the hospital. Those who couldn't function after 40 hours awake stood a good chance of washing out.
  • Why do so many people think that there is some mysterious conspiracy at the AMA or in medicine to control access to this field? Do you really think we are that afraid of competition? Twenty percent more docs in a few years isn't going to affect my income at all. Most of the areas I have worked were so underserved that an extra 20% would just be swallowed up and not even noticed. This is just paranoia, IMHO.
  • If you think docs aren't smart now, just wait. As medicine becomes more and more regulated, price controls will reduce the attractiveness of the field. In the words of one of my attendings, in our lifetime we will see double digit IQ's in medical school. Trust me, if it wasn't hard, everyone would do it. If you think we make so much money, why aren't you in this field? Or is it like the comedian's line, "I could have been a doctor. It was just that science stuff that was so hard."
I'm sorry for venting, but I just get tired of people dumping all over doctors. I don't know a single one of my colleagues with a "GOD" complex. That seems to be one of the most common criticisms and observations. We are just people with families who want to earn a living and help some people.

We are not greedy A**holes who are just in it for the money. I know very few doctors who think the money is worth it. There are lots easier ways, less threatening ways, to earn a living.

I really feel sorry for those people who have had such bad experiences that they hate doctors so much. Perhaps they went into the relationship with unrealistic expectations (GOD) and were disappointed when the person caring for them or their loved one turned out to be simply an everyday person, with all the attendant foilables.


I have yet to talk to a physician who wants to limit med school enrollment or read a post on a medblog recommending limits. This, at DB's Medical Rants, is much more typical.