medical Doctors and morality

[Shrykull]

What do you think about Doctors and morality, I mean with regard to why they are doctors, a friend of mine told me that tired cliche about medical professionals that went something like this "It's not about money or anything like that it's about ending pain and suffering."
While I believe yes a lot of doctors are compassionate, I know that a lot must also be in it for the money, it's one of the highest paid jobs you can get with raw education, unlike trying to run a business and make some profit. If it's about healing and only healing, why have thier own private practices, why not work in hospitals or overseas where they can service more people?

[Captain tycho]

What do you think about Doctors and morality, I mean with regard to why they are doctors, a friend of mine told me that tired cliche about medical professionals that went something like this "It's not about money or anything like that it's about ending pain and suffering."
While I believe yes a lot of doctors are compassionate, I know that a lot must also be in it for the money, it's one of the highest paid jobs you can get with raw education, unlike trying to run a business and make some profit. If it's about healing and only healing, why have thier own private practices, why not work in hospitals or overseas where they can service more people?

You also forget that many jobs involving medicine ar esome of the most stressful and hardest around, i.e. EM surgeon, etc..
But, yeah, alot of them are arrogant bastards who only got throuhg college because their rich parents sponsored them...
Wait, isn't that George W. Bush?

[TrailerParkJawa]

Many doctor's have private practices because they believe they can deliver much better care in that setting vs. working for an HMO.

[Strafe]

Have to remember that while many doctors do make a lot of money, they also have to pay a ton of money in malpractice insurance. I think it was West Virginia that had a large chunk of it's surgeons actually go on strike quite recently because of this problem.

[Alex Moon]

What do you think about Doctors and morality, I mean with regard to why they are doctors, a friend of mine told me that tired cliche about medical professionals that went something like this "It's not about money or anything like that it's about ending pain and suffering."
While I believe yes a lot of doctors are compassionate, I know that a lot must also be in it for the money, it's one of the highest paid jobs you can get with raw education, unlike trying to run a business and make some profit. If it's about healing and only healing, why have thier own private practices, why not work in hospitals or overseas where they can service more people?

Because it's fucking expensive to go to medical school. My roommate's father is a Dentist. After all his expenses, including malpractice insurance, his income is roughly $40,000. For the number of hours he puts in, it really isn't that much. The same thing goes for doctors.

[Darth Wong]

I've had good doctors and bad doctors. The fact that someone is a doctor does not tell you whether he is a moral person.

I can, however, state with some confidence that there's simply no way a doctor can see hundreds of patients every year for ten years and retain the kind of emotional investment in each that he had for his first 10 patients.

But as for morality, the standard behaviour of doctors is somewhat immoral, in the sense that they often charge you exorbitant fees for activities which require almost no effort on their part. For example, the "referral" fee. Most doctors will charge you for the act of simply referring you to another doctor, ie- a specialist! Think about that; if you go to an auto mechanic and he doesn't have the specialized knowledge or equipment he needs to service your car, would he fucking CHARGE you two hundred dollars to tell you where to go? An MD will. Or more accurately, he'll charge your health plan and you'll never know about it except for elevated overall costs.

And what about unnecessary surgery? There are THOUSANDS of unnecessary surgeries being conducted every year; the MAJORITY of hysterectomies are arguably unnecessary. This is exactly the same as an auto mechanic ripping you off for a new fuel-injector that you don't really need, except that it's not your car; it's your fucking life.

[Darth Wong]

BTW, when my mother used to work in a hospital many, many years ago, she saw a young woman come into the hospital for radiation therapy. The machine operator fucked up and gave the woman something like 20 times the dose she was supposed to get. The woman was dead within a month.

The family was told that she died of cancer. Technically, she did. No record was ever made of the mistake, and they were never told. Every staffer knew that to speak would be to lose his or her job, and my mother was a junior employee at the time, fearful to say anything. So it was quietly buried, and everyone told themselves that it didn't matter because she had cancer; she was going to die eventually anyway.

This is the kind of shit that goes on in hospitals.

[Edi]

But as for morality, the standard behaviour of doctors is somewhat immoral, in the sense that they often charge you exorbitant fees for activities which require almost no effort on their part. For example, the "referral" fee. Most doctors will charge you for the act of simply referring you to another doctor, ie- a specialist! Think about that; if you go to an auto mechanic and he doesn't have the specialized knowledge or equipment he needs to service your car, would he fucking CHARGE you two hundred dollars to tell you where to go? An MD will. Or more accurately, he'll charge your health plan and you'll never know about it except for elevated overall costs.

That's pretty fucked up. It doesn't happen here, fortunately. If you go someplace, whether public or private and the doctor can't help you, you'll still end up paying the fee for the examination, but when they refer you, that's for free. Of course, if they tried charging for it, the Consumer Rights Authority (yes, we have one of those, and they do a kick-ass job too) would fall on them like a ton of bricks. Not to mention that there are separate authorities and organizations that deal specifically with the medical community, and they'd have something to say too. The MD Union would also castigate the practice as unethical, and that would bring enough bad publicity on top of everything else that it'd kill business for people doing it.

Edi

[Edi]

BTW, when my mother used to work in a hospital many, many years ago, she saw a young woman come into the hospital for radiation therapy. The machine operator fucked up and gave the woman something like 20 times the dose she was supposed to get. The woman was dead within a month.

The family was told that she died of cancer. Technically, she did. No record was ever made of the mistake, and they were never told. Every staffer knew that to speak would be to lose his or her job, and my mother was a junior employee at the time, fearful to say anything. So it was quietly buried, and everyone told themselves that it didn't matter because she had cancer; she was going to die eventually anyway.

This is the kind of shit that goes on in hospitals.

How the hell is this sort of thing possible? I don't know how big a fan of central authority you are, but you need a dose more regulation, it seems. I can't really bring up any other example than Finland, because it's all I'm familiar with, but here anyone who dies will be autopsied if the family requests it, and the autopsy will be performed by the coroner, not just any doctor, especially not one from the hospital where that person died. Covering up an event like that would be very, very difficult, and if it was tried unsuccessfully (most likely outcome of any such attempt), every person involved would be fired and permanently banned from practicing medicine as well as having it written in bold red ink on their records why it happened. Of course, they'd be jailed on top of that too.

This isn't to say that shit doesn't happen occasionally, and when it does, it sucks. One of my best friends lost his grandfather due to a negligent nurse. His grandfather went to a hospital for a routine checkup and (IIRC) dialysis or some other routine procedure that required temporarily replacing a portion of his blood with the solution they use for rehydration. The nurse accidentally plugged a bottle of 90+% alcohol instead of the correct one (she'd put them side by side on a table, and apparently they were poorly labelled or not labelled at all). When the stuff reached his brain, he died, and there was nothing anyone could do. He was otherwise healthy, with a life expectancy of some years, though nobody could say for sure how many, he was so old he could have keeled over very soon, but it still sucks just as much ass.
There was an enquiry into the incident of course, and reprimands. I don't know if the nurse lost her job as a result or what the results were, my friend wasn't obviously in very high spirits and I didn't feel like pushing about the details and twisting the knife in the wound.

Mistakes happen sometimes, and it sucks, but that in itself is not criminal (unless it was brought about by gross or criminal negligence). Covering said mistakes up is, however, and deserves to be punished to the fullest extent possible.

I do realize that having a system like we do may not be feasible if the legal system encourages litigation and allows out-of-proportion damages, which would rule out the US, and quite possibly Britain, Australia and Canada too on account of their similar systems.

Edi

[Mr Flibble]

Firstly to the question of why people become doctors. I have a lot of med student friends and I have noticed the most common reasons for becoming a doctor are (in no particular order):
(1) Family wanting them to become a doctor (I even have experienced that pressure but resisted). It is most common in people whose parents are doctors.
(2) Here medicine and law have a reputation as the most respectable academic ourses to go intpo at university. This is mostly because they are the hardest to get into.
(3) Because it is something the person has always wanted to do
(4) To help people
(5) For the money
(6) Because they are an arrogant evil bastard like the person I talked about in this thread: http://bbs.stardestroyer.net/viewtopic.php?t=9987

As to once they become doctors why they lose some of that drive and go down easy paths, if they weren't already doing it for the money that is, a lot of energy and passion is (at least in South Australia) sucked out of them in their time as an intern. In this state the medical system is overstretched and it is the interns who have to bear the brunt of it, as a result they become cynical and jaded, so by the time they are finished they are just in it for themselves. However some good doctors make it through.

As to overcharging some of that is caused by exhorbatant insurance costs, where certain types of doctors are finding it nearly impossible to even break even in this country, and that is with high fees. We really need to fix our system as several important types of specialist are getting few on the ground because it is not worth the work. Other doctors are just greedy, or have an over inflated idea of their worth.

And medical incompetence abounds in our medical system due to it not having enough funding forcing doctors (mostly interns) and nurses to work extremely long shifts, jepordising their ability to make good judgements.

[Tsyroc]

How the hell is this sort of thing possible? I don't know how big a fan of central authority you are, but you need a dose more regulation, it seems. I can't really bring up any other example than Finland, because it's all I'm familiar with, but here anyone who dies will be autopsied if the family requests it, and the autopsy will be performed by the coroner, not just any doctor, especially not one from the hospital where that person died. Covering up an event like that would be very, very difficult, and if it was tried unsuccessfully (most likely outcome of any such attempt), every person involved would be fired and permanently banned from practicing medicine as well as having it written in bold red ink on their records why it happened. Of course, they'd be jailed on top of that too.

This isn't to say that shit doesn't happen occasionally, and when it does, it sucks. One of my best friends lost his grandfather due to a negligent nurse. His grandfather went to a hospital for a routine checkup and (IIRC) dialysis or some other routine procedure that required temporarily replacing a portion of his blood with the solution they use for rehydration. The nurse accidentally plugged a bottle of 90+% alcohol instead of the correct one (she'd put them side by side on a table, and apparently they were poorly labelled or not labelled at all). When the stuff reached his brain, he died, and there was nothing anyone could do. He was otherwise healthy, with a life expectancy of some years, though nobody could say for sure how many, he was so old he could have keeled over very soon, but it still sucks just as much ass.
There was an enquiry into the incident of course, and reprimands. I don't know if the nurse lost her job as a result or what the results were, my friend wasn't obviously in very high spirits and I didn't feel like pushing about the details and twisting the knife in the wound.

We had something similar happen at my hospital. A guy was in for a hip replacement and somehow the nurse got suction mixed up with oxygen. So instead of giving the guy more oxygen she sufficated him. This incident lead to hospital wide changes in how the various lines are labled. It involved a massive swap out of the types of hoses used throughout the hospital. My hospital admitted to being responsible for 4 deaths last year (including the one I mentioned). This was supposedly higher than our norm but considering the stupidity and lazziness of a lot of the people I work with I would bet that many more people are actually killed every year than are reported.

We also had some people sufficate waiting for X-rays because they were left alone and their oxygen bottles ran out. Now nurses are required to transport patients and someone has to be with the patient at all times. It was a rule before but because of their workload the nurses rarelly did it.

By the way, nurses only have to have a 2 year degree. There are a lot of 4year RNs but there are 2yr RNs and LPNs. A lot of times I find it very hard to believe that these people graduated from college because they often can't do basic math. Even more like to have their hand held whenever they do anything.

I'm sure it's going to get more interesting. My hospital is having so much trouble getting enough nurses that they are heavily recruiting in the UK and in India.