Ask Lemmy

Who's we? I'm certainly not okay with it

Momentum is hard to overcome and it’s been done this way for many many years

The guy who is largely attributed to making the medical residency system so punishingly difficult in terms of hours was coke addict btw. William Stewart Halsted. That was like 1890 and residents didn’t have their hours limited until 2003 (and even then, barely)

I'm not okay with it but it's the type of problem that can only be solved by them. They have to go on strike and protest.

Wait until they find out about pilots

This is actually an interesting question.

They experimented with “office hours” for doctors and patients were dying more than double/triple shift.

This because the information lost during handoff was more valuable than doctors being more tired (and by consequence doing more mistakes).

This is a textbook example of the risks of lost context

A lot of people have alluded to this already, but I'll simplify.

"We" are not OK with it. "We" are not the ones making the decisions

We're not. But, just like AI, executives with the ideology of rapists don't care about our consent.

Who would've thought that running every industry and business like mini dictatorships would backfire? Thanks capitalism!

The greatest fear of capitalist administrators is that there might be a slow night in the hospital and a few employees have some down time to take a breath where no "production" is taking place. The shareholders would not be amused. That's why they staff hospitals with the bare minimum, paying them as little as possible and using them as much as possible.

‘How does capitalism keep the unemployed on hand?’ you ask.

Simply by compelling you to work long hours and as hard as possible, so as to produce the greatest amount. All the modern schemes of ‘efficiency’, the Taylor and other systems of ‘economy’ and ‘rationalization’ serve only to squeeze greater profits out of the worker. It is economy in the interest of the employer only. But as concerns you, the worker, this ‘economy’ spells the greatest expenditure of your effort and energy, a fatal waste of your vitality.

It pays the employer to use up and exploit your strength and ability at the highest tension. True, it ruins your health and breaks down your nervous system, makes you a prey to illness and disease (there are even special proletarian diseases), cripples you and brings you to an early grave — but what does your boss care? Are there not thousands of unemployed waiting for your job and ready to take it the moment you are disabled or dead?

That is why it is to the profit of the capitalist to keep an army of unemployed ready at hand. It is part and parcel of the wage system, a necessary and inevitable characteristic of it.

It is in the interest of the people that there should be no unemployed, that all should have an opportunity to work and earn their living; that all should help, each according to his ability and strength, to increase the wealth of the country, so that each should be able to have a greater share of it.

But capitalism is not interested in the welfare of the people. Capitalism, as I have shown before, is interested only in profits. By employing less people and working them long hours larger profits can be made than by giving work to more people at shorter hours. That is why it is to the interest of your employer, for instance, to have 100 people work 10 hours daily rather than to employ 200 at 5 hours. He would need more room for 200 than for 100 persons — a larger factory, more tools and machinery, and so on. That is, he would require a greater investment of capital. The employment of a larger force at less hours would bring less profits, and that is why your boss will not run his factory or shop on such a plan. Which means that a system of profit-making is not compatible with considerations of humanity and the well-being of the workers. On the contrary, the harder and more ‘efficiently’ you work and the longer hours you stay at it, the better for your employer and the greater his profits.

You can therefore see that capitalism is not interested in employing all those who want and are able to work. On the contrary: a minimum of ‘hands’ and a maximum of effort is the principle and the profit of the capitalist system. This is the whole secret of all ‘rationalization’ schemes. And that is why you will find thousands of people in every capitalist country willing and anxious to work, yet unable to get employment. This army of unemployed is a constant threat to your standard of living. They are ready to take your place at lower pay, because necessity compels them to it. That is, of course, very advantageous to the boss: it is a whip in his hands constantly held over you, so you will slave hard for him and ‘behave’ yourself.

from Now and After by Alexander Berkman, Chapter 5: Unemployment. Available to read for free here.

Even in countries where healthcare is socialised, they are run "efficiently" like a capitalist business by administrators who care not for healthcare but for finances, "balancing the books", and bean counting.

The better question is why are the US Labor Laws still shitty. The Scandinavian countries leave everybody in their dust trail and the USA should simply copy them. Good luck finding the politicians, uncorrupt ones, that will change the laws.

Iirc, here in the UK it’s illegal to ask a doctor or nurse to work s triple shift. I think it should be for doubles as well, excepting major emergencies which involve a sudden influx of patients

Capitalism can only provide basic services to everyone if those services are borderline slavery. It works for all the basic needs : food, healthcare, construction.

One might say it only works through slavery for everything because most of the non essential things come from other countries you can call colonies. But the thing is that without redistribution the basic services cannot be paid correctly.

Capitalism has no pity.

No one does this outside of the USA. It is not at all normal, just like being stuck with the imperial system of measurements.

Because the wealthy can afford to have well-rested medical professionals at a moment's notice. Elites would care much more about the wellbeing of the typical doctor, if they had to have the ordinary doctor working on them.

Healthcare isn't the same as other jobs. It's better to do several 12 hour shifts in a row for 3-4 days than to take 5-6 8 hour shifts in a row. It's better to do them all in a row at once rather than take days off in between. Work when you have momentum. You will burn out a lot faster if you work every single day, even if it's for a short period of time.

You know what's funny? I actually think the situation is a lot better than you're making it out to be.

You're not entirely wrong. There absolutely are positions in hospitals where people do insane schedules like 24 or 48 hour shifts. But that's mostly concentrated around emergency medicine, trauma, surgical residency, ICU coverage, and certain on-call specialties. There’s definitely a culture surrounding ER staff and surgeons where sleep deprivation almost gets treated like some badge of honor.

But the majority of the medical world in America does not operate like that.

Most hospitals primarily run on normal shift structures. Nurses on regular floors and patient wings are usually working standard 8 or 12 hour rotations with multiple shift changes throughout the day just like any other industry. And once you get into private practice, some doctors are only in office a few days a week seeing a relatively small number of patients across different locations.

People also forget hospitals are not run exclusively by doctors and nurses. They're massive operations with huge amounts of support staff, technicians, imaging departments, transport, administration, custodial staff, billing, labs, and so on, most of whom work completely normal schedules.

So yes, what you're describing does exist. But I don't think it's remotely as universal or apocalyptic as people make it sound. A lot of public perception comes from dramatized media where every hospital is portrayed like a nonstop trauma center operating at DEFCON 1 twenty-four hours a day.

This is why a very conservative estimate of 1/20 hospital deaths are attributed to medical error.

my gf is a nurse and it is absolutely bonkers how the healthcare system works at all, shit is very run down and society as a whole needs a lot of shifting for how taxation affects the health care system. tax the fucking rich and make them pay their fair share and siphon that into healthcare.

No we're not. But generally governments everywhere want to starve the medical industry to make it generate profit for the wealthy. The US is their role model.

Glares at Doug Ford