Most Doctors Work While Sick, Despite Knowing It's Bad For Patients

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Most Doctors Work While Sick, Despite Knowing It's Bad For Patients

Posted by Soulskill on Tuesday July 7, 2015 @12:45PM from the gotta-pay-off-that-medical-school-debt dept.

An anonymous reader writes: A new survey published in JAMA Pediatrics found that 95% of doctors believe patients are put at risk when doctors work while sick. Despite that, 83% of respondents said they had "come to work with symptoms like diarrhea, fever and respiratory complaints during the previous year." The researchers doing the survey dug into the reasons for this: first of all, given the heavy workload of most doctors, it's very difficult to find others who can take up the slack when one is recovering from an illness. Beyond that, the profession is pervaded by a culture of working through the discomfort and pain of minor maladies. According to a commentary on the research, hospital policies don't help matters — they often incentivize long hours and don't encourage ill workers to leave the premises.

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Coincidentally... by garyisabusyguy · 2015-07-07 12:48 · Score: 1

Doctors ALWAYS know what is best for their patients /snark

--
Wherever You Go, There You Are
1. Re:Coincidentally... by mjm1231 · 2015-07-07 12:59 · Score: 3, Insightful
  
  They might. The current system does not necessarily give them incentive to _do_ what's best though. Still, modern medicine beats whatever is in second place by a long long way.
  
  --
  Ideology: A tool used primarily to avoid the bother of thinking.
2. Re:Coincidentally... by jellomizer · 2015-07-07 13:07 · Score: 4, Insightful
  
  Doctors are paid per service, they take the time off they don't get paid.
  If they have a small practice then it is their whole staff that won't work that day so it is also 2 - 4 more people missing work. And those don't get paid nearly as well as the Doctor so they will really hurt.
  
  --
  If something is so important that you feel the need to post it on the internet... It probably isn't that important.
3. Re:Coincidentally... by jd2112 · 2015-07-07 13:33 · Score: 5, Funny
  
  Plus they could get to treat their patient again for whatever illness they gave them. Bonus!
  
  --
  Any insufficiently advanced magic is indistinguishable from technology.
4. Re:Coincidentally... by tchdab1 · 2015-07-07 17:58 · Score: 1
  
  Where do you think the doctor contracted the thing(s) making them sick?
  How many of us work in an environment full of sick people?
5. Re:Coincidentally... by Jack+Griffin · 2015-07-07 20:47 · Score: 2, Insightful
  
  I haven't had much experience with Doctors fortunately, but the last few visits made me feel like they were the equivalent of 1st level helpdesk. Issues were either googled, or simply told to take some antibiotics and come back if it gets worse (ie the reboot). When you look at how much a modern economy spends on healthcare, I think there is room for a different health model which is a lot cheaper and more efficient.
6. Re:Coincidentally... by CrimsonAvenger · 2015-07-07 22:50 · Score: 1
  
  I haven't had much experience with Doctors fortunately, but the last few visits made me feel like they were the equivalent of 1st level helpdesk.
  I HAVE had a lot of experience with doctors recently (defined as the last ten years). And my impressions of the various doctors that have treated me have been universally positive.
  Of course, all my doctors except my Priimary Care guy work at a University Hospital, and so, presumably, are a bit better than the average.
  
  --
  
  "I do not agree with what you say, but I will defend to the death your right to say it"
7. Re:Coincidentally... by dr.Flake · 2015-07-07 23:45 · Score: 1, Informative
  
  Actually,
  I am a medical doctor, and work in a government owned hospital. That makes me kind of a civil servant. I get paid per month, not per patient/treatment.
  I completely recognize my colleagues and myself in this report. One doesn't call in sick, unless one has 39,5C fever or isn't capable of driving the car to work.
  Financial interest has nothing to with this, your remark reflects your utter ignorance for the matter and lacks any form of humour.
  
  --
  Why are other peoples sig's always more witty ???
8. Re:Coincidentally... by sjames · 2015-07-07 23:54 · Score: 2
  
  Not all modern medicine is the same and IMHO, it is in decline in the U.S.
  In the U.S. we have the most expensive healthcare by far, but the result is among the worst in the 1st world. It's rapidly approaching the point where we could replace doctors entirely with an expert system that walks the diagnostic tests then prescribes the most expensive drug at the end of the tree. Clinical diagnosis is dead.
9. Re:Coincidentally... by Anonymous Coward · 2015-07-08 00:12 · Score: 0
  
  How do you explain the 5% of doctors who don't think working while sick puts patients at risk?
10. Re:Coincidentally... by ranton · 2015-07-08 01:59 · Score: 2
  
  I am a medical doctor, and work in a government owned hospital. That makes me kind of a civil servant. I get paid per month, not per patient/treatment.
  I completely recognize my colleagues and myself in this report. One doesn't call in sick, unless one has 39,5C fever or isn't capable of driving the car to work.
  Financial interest has nothing to with this, your remark reflects your utter ignorance for the matter and lacks any form of humour.
  Are you claiming there are no doctors who get paid per visit or per service offered? Because unless that is the case, your remarks reflect your utter ignorance for the matter.
  Even for you and your colleague who never calls in sick, I doubt there are no financial interests at play. Do you have a limited number of sick days? Do you have to take vacation days after those sick days are exhausted? Are you compensated at the year's end for unused sick days? Are your sick days and vacation days all combined into a single PTO group? Does your hospital not keep enough staff on hand to cover for sick doctors? If you said "Yes" to any of these questions then there are financial interests at play.
  These issues are either caused by financial interests, ignorant doctors, or doctors who don't care about their patients' health. I am betting on the first, and would be very sad if you think it is one of the two latter explanations.
  
  --
  -- All that is necessary for the triumph of evil is that good men do nothing. -- Edmund Burke
11. Re:Coincidentally... by BVis · 2015-07-08 02:00 · Score: 1
  
  They're American? It's another sign of the "you're not allowed to be human" treatment that lots of American workers get. Even people who get sick time are discouraged from taking it, lest it reflect badly on their performance. If they'd also not get paid for that day, hell yeah they're going to drag their sorry asses to work and give everyone in the office the plague, because, you know, it's much better for 5 people to work at half capacity than give 1 person the day off to recover. Lazy shiftless assholes, they should work harder, not be sick.
  
  --
  Never underestimate the power of stupid people in large groups.
12. Re:Coincidentally... by Anonymous Coward · 2015-07-08 02:46 · Score: 0
  
  You're telling me that if you go to the doctor in America there is .83*(1/365)=.23% chance they are sick, minimum. Each additional day they come to work sick will increase this, 10 sick days/year makes it a 1/50 chance. Worse there is a 1/20 chance that if they get you sick, they will berate you for complaining about it for having poor work ethic?
13. Re:Coincidentally... by bingoUV · 2015-07-08 03:44 · Score: 1
  
  How many of us work in an environment full of sick people?
  Those many of us who benefit from sick people?
  
  --
  Bingo Dictionary - Pragmatist, n. A myopic idealist.
14. Re:Coincidentally... by dr.Flake · 2015-07-08 03:58 · Score: 1
  
  Off course there are hospitals and doctors over here that are being paid by the patient/treatment. But, like i said, the same work ethos applies to those who are not financially inclined to come. That indicates that the financial interest is not the (main) reason for this behaviour. I see this in all civil servant doctors as well.
  We are talking single / couple of days sick leave here, having the flu, headache or diarrhoea. not long term illnesses / disability.
  # Do you have a limited number of sick days? This is Europe talking,, Sick day's ?? you mean you guys have a limited number of days you are allowed to be ill? That's sick. You have to be away from work a lot / long period at one stretch to get into trouble. Disabilty laws kick in at that point. Whole different ballgame concerning financial interests. Having no sick days or having 10 during the year doesn't influence a penny on my wages.
  # Do you have to take vacation days after those sick days are exhausted? Sorry??, again. You have to take up vacation days due to being ill? Ps, I have 5 weeks holiday/year.
  # Are you compensated at the year's end for unused sick days? see above, no.
  # Are your sick days and vacation days all combined into a single PTO group? no
  # Does your hospital not keep enough staff on hand to cover for sick doctors? no, barely enough even when everybody is working. Being ill can lead to patients not being seen on the out patient clinic that day and chances are they will have to wait for an open spot on the schedule. Off course the severity of the patients condition influences the amount of delay. Surgery is being cancelled sporadically. Europe may be social, but not communistic
  # If you said "Yes" to any of these questions then there are financial interests at play.
  conclusion:
  no financial interest
  You do realise you are often infectious to others before you are aware of being ill or even becomming ill at all? For instance for the flu, noro or chicken-pox. The whole "come in and infect everybody in the office / clinic" argument is really weak. People get sick via all sorts of routes.
  
  --
  Why are other peoples sig's always more witty ???
15. Re: Coincidentally... by sabbede · 2015-07-08 05:16 · Score: 1
  
  There's also far more demand for their services then they can supply, and patient needs are often too urgent to delay.
16. Re:Coincidentally... by Anonymous Coward · 2015-07-08 06:37 · Score: 0
  
  This is why we (Americans) need paid sick leave.
  A payroll tax. Perhaps half paid by employee, half paid by employer.
  Capped at 5000 times the federal minimum wage for what can be taxed annually. 5000 * $7.25 = $36,250.
  For every 50 * $7.25 = $362.50 earned up till the annual limit, one sick hour credit worth $7.25 is accumulated.
  Figures adjusted annually for federal minimum wage. However, I don't know if earned credits should be adjusted for inflation for when they are used.
  No more than 60% of base pay can be recovered.
  Example.
  Salaried person earns $70k per year.
  Sick pay payroll tax is only on the first $36,250 of that income. Perhaps pay for by employer and employee alike. The percent to be determined by actuaries.
  Let's say the person has only worked enough in the year to earn $20,000 and this is the first year in which the program has been in effect.
  $20,000 / $362.50 = 55 credits when rounded down.
  55 credits at $7.25 each = $398.75.
  60% of base pay means $398.75 * 100/60 = $664.58.
  Assuming a 2000 hour work year, this means a salary of $70k/year yields $35/hour (even if the person is working more or less than 40 hours per week).
  $664.58 / $35/hour = 18.988. So, about 19 hours or 2.3735 days.
  So, this person can take 2 days off work due to illness and recover (8 hours/day * 2 days * $35/hour * 0.6) = $336 in lost income. Of course, that maxes out all the credit earned in this 'first year the program has been in effect' example.
  Maybe a fast food employee has been working 5 years (10,000 hours at $7.25/hour). That is $72,500 grossed in those 5 years. $72,500 / $362.50/credit = 200 credits earned at $7.25/credit.
  Let's say this employee gets sick for a week.
  8 hours/day * 7 days * $7.25/hour = $406 in lost income.
  The sick pay would be 60% of that, or $243.60. That's over 7 normally worked days though, so probably a 9 day span including weekends.
  This means that 200 credits at $7.25 have been reduced to ($7.25/credit * 200 credits = $1450, subtract $243.60 used, we get $1206.40 left. At $7.25/credit, that's 166.4 credits. I forgot to do some rounding, but you get the idea.)
  An actuary would be needed to figure out the percentage. We'd need to know the odds of getting sick. The lower the odds for everyone overall, the lower the uniform rate we have. I don't think we should discriminate based on age, gender, etc. otherwise we could get employers discriminating against potential hires if they pay half the payroll for this sick pay payroll insurance scheme.
17. Re:Coincidentally... by painandgreed · 2015-07-08 07:12 · Score: 1
  
  I haven't had much experience with Doctors fortunately, but the last few visits made me feel like they were the equivalent of 1st level helpdesk. Issues were either googled, or simply told to take some antibiotics and come back if it gets worse (ie the reboot). When you look at how much a modern economy spends on healthcare, I think there is room for a different health model which is a lot cheaper and more efficient.
  Essentially, you are at a 1st level helpdesk. Human body or computer, there's no quick track that skips proper troubleshooting, and proper troubleshooting sometimes takes time. Trouble is that there is no tier 2 helpdesk that isn't dedicated to a specific field, which they will send you to once they determine what it is. From there, if they can figure out the specific issue, you can go to a tier 3 helpdesk of a specialist. Patients, like users might try and skip the tier 1 helpdesk, but chances are, the tier 2 guy issuing to have to do the same troubleshooting, just at an increased cost and perhaps send you back to tier 1 because you are seeing somebody in the wrong friend, because patients, like users, using have no idea what they are doing and if they think they do, are usually wrong. That being said, there does exist a wide range of experience and competence at all tier levels.
18. Re:Coincidentally... by AK+Marc · 2015-07-08 08:19 · Score: 1
  
  Sick day's ?? you mean you guys have a limited number of days you are allowed to be ill?
  There's no practical limit to the number of days you can be sick, but a limit on the number of sick days that are paid. So you call in "sick" on the sunny days, and go to work on the days you are sick.
  
  Also, in the US, most PTO is in a single group. You get paid time off, regardless of whether it's "sick" "vacation" or such. So taking a day when you are actually sick will reduce the number of days you have for vacations.
  
  --
  Learn to love Alaska
19. Re:Coincidentally... by david_thornley · 2015-07-08 08:33 · Score: 1
  
  I've had several health issues in the past ten years. Without exception, the doctors were concerned, knew what they were doing, and gave me the information I needed and made sure I understood it. I had my left cornea smoothed out and a clot removed from a coronary artery, both faster than I realized possible. When the doctors didn't know something (and the human body is complicated) they told me that. (Fortunately I have excellent health insurance.) I don't know where you found your doctors, but my experience is completely different.
  We clearly have room for a cheaper and more efficient health care system (we spend much more on health care per capita than any other country), but I really like the results I've been getting.
  
  --
  "When you have eliminated the unacceptable, whatever is left, however improbable, must be the truthiness" - Holmes
20. Re:Coincidentally... by david_thornley · 2015-07-08 08:35 · Score: 1
  
  US health care is actually very good, provided you can afford it. Our crap public health statistics are because we keep a large number of people from getting said health care.
  
  --
  "When you have eliminated the unacceptable, whatever is left, however improbable, must be the truthiness" - Holmes
21. Re:Coincidentally... by sjames · 2015-07-08 09:01 · Score: 1
  
  Healthcare that you can't afford is for all practical purposes non-existent.
  But in fact, even for those who can pay, we come in at 18th place.
22. Re:Coincidentally... by ranton · 2015-07-08 14:22 · Score: 1
  
  # Does your hospital not keep enough staff on hand to cover for sick doctors? no, barely enough even when everybody is working.
  Then your actual answer to my question was Yes. Yes your hospital does not keep enough staff on hand to cover for sick doctors. So there is a financial interest for why doctors in your hospital work when sick, its just that your employer (in your case probably the tax payers) are reaping the benefits of cheaper health care. There is an amount of money that could be paid for health care which could hire enough doctors where none of you would have to work when sick.
  A more free market does allow for different tiers of care, although the top care is then limited to those with the most money. This is generally how it is in the US, where health care for those in the upper class is arguably the best in the world, but a large percentage of people receive little to no care. Americans often complain that socialized medicine would delay care like you mention in your post, but this is generally only a concern for those with money.
  
  Off course there are hospitals and doctors over here that are being paid by the patient/treatment. But, like i said, the same work ethos applies to those who are not financially inclined to come. That indicates that the financial interest is not the (main) reason for this behaviour. I see this in all civil servant doctors as well.
  Financial interest is still the main reason why your industry forces such a work ethic on doctors. Doctors are not born with that work ethic, it is ingrained into them by an industry that requires that level of commitment because of how it is operated. Health care would be more expensive if the economy supported the number of doctors necessary for doctors to take the likely 20+ sick days per year that would be necessary to not work when sick.
  
  You do realise you are often infectious to others before you are aware of being ill or even becomming ill at all? For instance for the flu, noro or chicken-pox. The whole "come in and infect everybody in the office / clinic" argument is really weak. People get sick via all sorts of routes.
  People are not automatically infected with someone by being in the same workplace. The length of time and frequency of contact are huge factors in whether a contagion is transferred to a coworker. So one day of exposure compared to three to four days of exposure greater impact the chances you will spread your contagion to one or more coworkers.
  
  --
  -- All that is necessary for the triumph of evil is that good men do nothing. -- Edmund Burke
23. Re:Coincidentally... by Anonymous Coward · 2015-07-08 19:48 · Score: 0
  
  You don't understand. 5% of doctors think that if they are sick their patients are not "put at risk" of either contracting the illness themselves or errors due to reduced performance.
24. Re:Coincidentally... by Jack+Griffin · 2015-07-08 22:43 · Score: 1
  
  Essentially, you are at a 1st level helpdesk. Human body or computer, there's no quick track that skips proper troubleshooting, and proper troubleshooting sometimes takes time. Trouble is that there is no tier 2 helpdesk that isn't dedicated to a specific field, which they will send you to once they determine what it is.
  From my limited, anecdotal evidence, I wonder how many others consume precious doctor resources with non-serious issues that could be addressed by a real level 1 service such as a nurse.
  Push the doctor to Level 2, the Specialist to level 3, and introduce a less qualified person into level 1. All those people with colds and flu, cuts and bruises, even minor breaks can be diagnosed by most nurses.
  I don't know the real numbers but based on my experience in waiting rooms this would cut doctor visits by at least half.
25. Re:Coincidentally... by Anonymous Coward · 2015-07-08 23:35 · Score: 0
  
  Modern medicine beats old medicine, but what this story proves is that the majority of doctors are in it for the money and the money only -- rather than helping others, making the world a better place, etc (as popular culture portrays them). Obviously, a doctor who puts more importance on the patient's health than business would never consider exposing the patient to unnecessary risk.
  I've long believed that doctors are no more or less noble than lawyers, and this latest story just solidifies my conclusion. They are all driven primarily by money.
As a physician... by NigelTheFrog · 2015-07-07 12:53 · Score: 5, Interesting

...I can agree this is totally true. Calling in sick does nothing but make my life harder. I feel bad about it, but from a job perspective, the alternative is piss off your co-workers who have to cover for you and get tagged with the reputation that you're lazy and trying to avoid work. Combine that with the need to get a doctor's excuse (another doctor; can't write your own), and it's just not worth it.
1. Re:As a physician... by jellomizer · 2015-07-07 13:10 · Score: 1
  
  I hope if you are going in sick to work you are taking extra care to protect the patients from your illness. Such as wearing a mask and just a bit more complete washing.
  
  --
  If something is so important that you feel the need to post it on the internet... It probably isn't that important.
2. Re:As a physician... by Rick+Zeman · 2015-07-07 13:23 · Score: 1
  
  Plus, you can't bill from bed.
3. Re:As a physician... by Anonymous Coward · 2015-07-07 13:28 · Score: 5, Interesting
  
  I've worked as a physician with an IV in my arm during a bout of diarrhea and vomiting I caught from a patient (despite thorough hand washing). I've worked with pneumonia I caught from a patient. Its not always the physician passing the disease to the patient. In my experience it has been more likely for the physician to get what our patients have.
  Also as an employee as opposed to a fee for service type physician, there is still the drive to work as to not pass your work onto other physicians. Its part of the mentality of "I can work through anything" similar to why you hear about surgeons working for 30+hrs straight.
4. Re:As a physician... by PvtVoid · 2015-07-07 13:45 · Score: 3, Insightful
  
  I've worked as a physician with an IV in my arm during a bout of diarrhea and vomiting I caught from a patient (despite thorough hand washing). I've worked with pneumonia I caught from a patient. Its not always the physician passing the disease to the patient. In my experience it has been more likely for the physician to get what our patients have.
  Whereupon you'll transmit it to another patient. Selection bias much?
  I submit Parent as Poster Child for the problem.
5. Re:As a physician... by gurps_npc · 2015-07-07 14:01 · Score: 5, Insightful
  
  I can tell you that as just an office worker, I get PISSED when my co-worker comes in with a cough, I know I will end up getting it.
  I would rather work harder and longer hours today than have to take off a day myself (and possibly come in a day or two when I am recovering myself).
  I know of NO ONE in my office that doesn't think people should stay home when we are sick.
  Of course, it helps that I work for a law firm that is more concerned with obeying the law than most work places.
  I think this is one aspect of poor management., Management sets the tone - do they complain etc. when you call in sick? If they don't, then people take off when they are sick.
  It is truly a shame that hospital management is so penny-wise/pound foolish as not to insist on generous sick time.
  
  --
  excitingthingstodo.blogspot.com
6. Re:As a physician... by PopeRatzo · 2015-07-07 14:08 · Score: 5, Insightful
  
  Calling in sick does nothing but make my life harder. I feel bad about it
  There's your problem right there. If you're sick, you're sick. You already feel bad, so beating yourself up for staying home is just giving in to this ridiculous work ethic. And that work ethic? It's nothing but crude mind control. We're told that we're supposed to have a special "ethic" that means if you're not suffering, you're not earning your pay. And if your job requires you to get a doctor's excuse to take a day off work, you need to give notice tomorrow and find another job.
  The corporatists have done a number on your head. Resist it.
  
  --
  You are welcome on my lawn.
7. Re:As a physician... by PopeRatzo · 2015-07-07 14:10 · Score: 2
  
  why you hear about surgeons working for 30+hrs straight.
  I really don't want a surgeon who's been up for 29 hours doing any procedure on me.
  
  --
  You are welcome on my lawn.
8. Re:As a physician... by Anonymous Coward · 2015-07-07 14:36 · Score: 0
  
  I can tell you that as just an office worker, I get PISSED when my co-worker comes in with a cough, I know I will end up getting it.
  Same here. Assuming that management or other office influences aren't forcing a sick worker to come in, I think it would be pretty cool that if a co-worker comes into the office sick without taking the day off, then other co-workers that work with that individual get to take that day off as a sick day (to prevent getting sick). The "sick" day the co-workers use then comes out of the sick co-workers' allotment.
  Both parties then win - the sick worker gets to work since they refused to stay home, and the healthy co-workers get to stay healthy. Done :)
9. Re: As a physician... by Anonymous Coward · 2015-07-07 15:04 · Score: 0
  
  In Soviet Russia, you get sick when go to doctor.
10. Re:As a physician... by Anonymous Coward · 2015-07-07 15:11 · Score: 0
  
  Sounds like this trumps the 'do no harm' ethos as well. :-(
11. Re:As a physician... by David_Hart · 2015-07-07 15:24 · Score: 1
  
  Calling in sick does nothing but make my life harder. I feel bad about it
  There's your problem right there. If you're sick, you're sick. You already feel bad, so beating yourself up for staying home is just giving in to this ridiculous work ethic. And that work ethic? It's nothing but crude mind control. We're told that we're supposed to have a special "ethic" that means if you're not suffering, you're not earning your pay. And if your job requires you to get a doctor's excuse to take a day off work, you need to give notice tomorrow and find another job.
  The corporatists have done a number on your head. Resist it.
  If I'm sick, I stay home. No sense in passing what I have to the rest of my coworkers. The reality is that it's actually best for the company if I do. Which would they rather happen, one worker stays home for a couple of days to recover or that person goes to work and they lose productivity from 10 others that then get sick...
  This finding goes to show that even smart people are stupid even about the most basic things and that familiarity breeds contempt. I wonder how much of this has to do with the Doctors being around sick patients all of the time and getting complacent. The worse part is that they could compromise someone whose immune system is already weak from another disease.
  A Doctor should know better......
12. Re: As a physician... by Anonymous Coward · 2015-07-07 15:45 · Score: 1
  
  As a private practice physician you can't find coverage on a moments notice, bills still need to get paid and you have no revenue without patient visits. Refills, lab results, disability forms and all sorts of other random shit piles up that only you can do and people are really ticked when they don't get it now. (Not to mention lab, imaging reports and other shit that comes piling in. ). Being a doctor is pretty shitty in many ways. Everyone things we are over paid and that we pretty much belong to them. Honestly there is no alternative to coming in sick, missing your children growing up and just plane missing out on big swaths of your life. I would stop if I could find something to pay my debts and someone who. Would take care of my patients.
13. Re:As a physician... by Anonymous Coward · 2015-07-07 16:53 · Score: 4, Interesting
  
  Cry me a river. The reason why physicians have to work so hard is because the AMA deliberately keeps the supply of doctors small, and deliberately ensures that health care can only be dispensed by their overpaid members. Hospitals and insurance agencies have their own rent seeking arrangements. And half the time, patients come out sicker than they go into the hospital.
  Physicians are a necessary evil. Some of them even have good intentions going into the profession. Don't expect any admiration simply for your job title or your self-inflicted working hours. Oh, and your conduct sounds irresponsible.
14. Re:As a physician... by Anonymous Coward · 2015-07-07 16:55 · Score: 1
  
  I have to take immunosuppressants for a chronic condition. Maybe I should just die as an inferior mutation. Meanwhile, I will catch that cough every time.
  Something you can fight off in a few days means a doctor's appt, time off work, prescriptions, and co-pays for me.
  I got walking pneumonia after 6 months of the whole office taking turns coughing. I avoided meetings if possible, did not shake hands, washed hands compulsively, and in general seemed like a terrible person. Started coughing, saw the doc, got the right antibiotics, oh did I mention I take antibiotics regularly? But not the ones that work on walking pneumonia. So another appt, another prescription, and
  I FELT HORRIBLE BECAUSE YOU ASSHOLES CAME TO WORK SICK.
  Seriously, you are costing money. And more if someone is on some sort of meds that you're not aware of
15. Re:As a physician... by Anonymous Coward · 2015-07-07 17:01 · Score: 0
  
  I really don't want a surgeon who's been up for 29 hours doing any procedure on me.
  Maybe you don't, but the surgeon wants a new car.
16. Re:As a physician... by alvinrod · 2015-07-07 17:04 · Score: 2, Insightful
  
  You don't always get to make that choice and sometimes it's either surgery from some poor overworked bastard to keep you alive or not living through the misfortune. Some surgeons don't always get to have nice and neat schedules. Occasionally fate intervenes and there are a lot of people in need of help due to disaster or other terrible cause.
17. Re:As a physician... by Anonymous Coward · 2015-07-07 17:09 · Score: 0, Troll
  
  "Calling in sick does nothing but make my life harder. I feel bad about it, but from a job perspective, the alternative is piss off your co-workers who have to cover for you and get tagged with the reputation that you're lazy and trying to avoid work"
  Glad to see you're taking that Hippocratic oath seriously... Your first duty is to your patients, not your co-workers.
18. Re:As a physician... by EzInKy · 2015-07-07 18:40 · Score: 2, Insightful
  
  Fine. And, since chances are good that that surgeon will be the only one available in many parts of the world, you will die for lack of a life saving procedure.
  
  --
  Time is what keeps everything from happening all at once.
19. Re:As a physician... by Anonymous Coward · 2015-07-07 19:53 · Score: 0
  
  Dear surgeons:
  Please do not operate on me if you've been up for more than 14 hours, sincerely, everyone.
20. Re:As a physician... by Anonymous Coward · 2015-07-07 21:44 · Score: 0
  
  even smart people are stupid
  I tried to find evidence for the assumption that doctors are smart, it turns out their IQ is between 160-240:
  http://anepigone.blogspot.com/2011/01/average-iq-by-occupation-estimated-from.html
21. Re:As a physician... by Anonymous Coward · 2015-07-07 21:46 · Score: 0
  
  I don't think people quite understand the issue. It's not sick time. I'm one of only 2-3 neurosurgeons in a the hospital at a given time and there is so much critical work that we're all needed there at once. To have someone cover me would be problematic since they are already working 80-100 hours per week already, so they would go over the policy limits for work hours, or at the very least be very very unhappy about it.
22. Re:As a physician... by Anonymous Coward · 2015-07-07 22:50 · Score: 0
  
  I've worked as a physician with an IV in my arm during a bout of diarrhea and vomiting I caught from a patient (despite thorough hand washing). I've worked with pneumonia I caught from a patient. Its not always the physician passing the disease to the patient. In my experience it has been more likely for the physician to get what our patients have.
  Also as an employee as opposed to a fee for service type physician, there is still the drive to work as to not pass your work onto other physicians. Its part of the mentality of "I can work through anything" similar to why you hear about surgeons working for 30+hrs straight.
  It is inbred and taught into the profession. This is the field where work-life balance translates to "work till you're mid-forties or fifty, then get a life."
  After killing yourself with no free time in med school, (may have changed), internships post graduation had to be capped to 90 hours a week. There are beds at work so you don't lose time commuting home. Yes, it improves, but a 10% improvement doesn't bring it within the boundaries of sane.
  So if you get the mentality "I can work through anything" perhaps it came from med school being increasingly "make them work through stuffing three and a half year's of information into their heads in two years" and internships being "make them stuff four years of experience into two".
23. Re:As a physician... by Anonymous Coward · 2015-07-07 22:53 · Score: 0
  
  Calling in sick does nothing but make my life harder. I feel bad about it
  There's your problem right there. If you're sick, you're sick. You already feel bad, so beating yourself up for staying home is just giving in to this ridiculous work ethic. And that work ethic? It's nothing but crude mind control. We're told that we're supposed to have a special "ethic" that means if you're not suffering, you're not earning your pay. And if your job requires you to get a doctor's excuse to take a day off work, you need to give notice tomorrow and find another job.
  The corporatists have done a number on your head. Resist it.
  While I agree that too much work can be very bad, the opposite is likewise true.
  I hate to dwell on it, but I know some people who's work ethic makes getting up from the sofa to grab a bag of chips sound like an accomplishment.
24. Re:As a physician... by sjames · 2015-07-08 00:06 · Score: 1
  
  Honestly, knowingly going in to work sick should be considered assault. It's no different than doping the food in the break room.
  That would mean that a manager that somehow pressures employees to work sick would be guilty of a crime as well.
25. Re:As a physician... by PopeRatzo · 2015-07-08 00:08 · Score: 1
  
  Fine. And, since chances are good that that surgeon will be the only one available in many parts of the world, you will die for lack of a life saving procedure.
  This is from the article:
  
  At the Children’s Hospital of Philadelphia, Julia E. Szymczak and colleagues analyzed survey responses collected last year from 536 doctors and advanced practice clinicians at their institution.
  See that? Philadelphia. I'm pretty sure there is more than one surgeon available in Philadelphia. This is not some field hospital in Kenya and I'm not getting this surgery for free.
  Does my bill for the surgery get pro-rated downward if the surgeon is impaired due to being tired?
  
  --
  You are welcome on my lawn.
26. Re:As a physician... by PopeRatzo · 2015-07-08 00:09 · Score: 1
  
  I don't think people quite understand the issue. It's not sick time. I'm one of only 2-3 neurosurgeons in a the hospital at a given time and there is so much critical work that we're all needed there at once. To have someone cover me would be problematic since they are already working 80-100 hours per week already, so they would go over the policy limits for work hours, or at the very least be very very unhappy about it.
  This is why God invented labor unions, doctor.
  
  --
  You are welcome on my lawn.
27. Re:As a physician... by Drethon · 2015-07-08 00:29 · Score: 1
  
  I get pissed off when I have to come into work with a cold. Unfortunately as an engineer I'm usually deep into a project that would take hours or days to switch over to someone else. We also get 3 sick days a year and I'm prone to colds that transition into a cough that lasts more than a week. Not a lot of options if I want to stay employed.
28. Re:As a physician... by Anonymous Coward · 2015-07-08 00:41 · Score: 0
  
  Nice work environment you got there. If my coworkers come to work sick I tell them to get the fuck out, I don't want to get whatever they have. My boss does the same. Also, we don't need a doctors excuse for short common things. If it looks like it won't go away you go see a doctor (which, at that point, is smart thing anyways). People get sick, there is no slacking there, but there is a lot of stupidity in coming to work while sick to infect others. The end result is you get to cover in turn for EVERYONE. If the sick stay home you only cover for one every now and then. Employers around here are luckily smart enough to see it.
29. Re:As a physician... by Anonymous Coward · 2015-07-08 00:46 · Score: 0
  
  It must be nice to have a job where you're not essential.
30. Re:As a physician... by DigiShaman · 2015-07-08 00:46 · Score: 1
  
  I doubt that's true for elective surgeries.
  
  --
  Life is not for the lazy.
31. Re:As a physician... by David_Hart · 2015-07-08 00:57 · Score: 1
  
  I don't think people quite understand the issue. It's not sick time. I'm one of only 2-3 neurosurgeons in a the hospital at a given time and there is so much critical work that we're all needed there at once. To have someone cover me would be problematic since they are already working 80-100 hours per week already, so they would go over the policy limits for work hours, or at the very least be very very unhappy about it.
  So, because of bad management practices you would rather work yourself to death and put others in jeopardy health wise? How do you take vacations? What happens if you get hit by a bus?
  If you and your peers are consistently working 80 to 100 hours a week then you guys are just plain crazy. All of you will be burned out within 2 years and end up with your own health problems. There is obviously enough work to hire more employees. If management is saying that they can't find talent, then they are probably not trying hard enough. At the very least, I'm sure that there are young talented doctors out there that you could train and mentor.
32. Re:As a physician... by tsqr · 2015-07-08 02:11 · Score: 1
  
  It must be nice to have a job where you're not essential.
  So your absence for a few days would be inevitably and irrevocably devastating to your employer's business? You must be quite the rare bird.
  Some employees are very valuable, and a few are so valuable that their absence is a significant inconvenience. I'm sure they're missed when they take vacations, too.
33. Re:As a physician... by Anonymous Coward · 2015-07-08 04:40 · Score: 0
  
  Dear surgeons:
  Please do not operate on me if you've been up for more than 14 hours, sincerely, everyone.
  Dear Patient,
  Please don't become sick or get injured 13 hours and 59 minutes into my 36 hours shift.
  Sincerely,
  Your Surgeon
34. Re:As a physician... by digitalPhant0m · 2015-07-08 05:07 · Score: 1
  
  I know of NO ONE in my office that doesn't think people should stay home when we are sick.
  Same in my office, yet people still come in sick (despite everyone pleading with them to go home) because they want to show everyone else what a hard worker they are.
35. Re: As a physician... by sabbede · 2015-07-08 05:21 · Score: 1
  
  And if you're a doctor, taking a sick day could mean not saving lives. If you're the only doctor for miles, "I have pneumonia" ain't gonna override, "my wife is bleeding to death, please help!"
36. Re:As a physician... by TemporalBeing · 2015-07-08 06:28 · Score: 1
  
  I don't think people quite understand the issue. It's not sick time. I'm one of only 2-3 neurosurgeons in a the hospital at a given time and there is so much critical work that we're all needed there at once. To have someone cover me would be problematic since they are already working 80-100 hours per week already, so they would go over the policy limits for work hours, or at the very least be very very unhappy about it.
  This is why God invented labor unions, doctor.
  Except God didn't; man did.
  
  And labor unions would not necessarily make things much better. Many nurses work for under a union, and it tends to create the "well, it's not my job to do X" mentality, because if you're in a union and you do your job but could have done X that is Jane's or Joe's job then you get penalized despite it being faster for you to do it than calling Joe or Jane to do so. It's also why it costs $19 to get an aspirin in the hospital.
  
  --
  Truth is like the sun. You can shut it out for a time, but it ain't goin' away. - Elvis Presley (source: imdb.com)
37. Re:As a physician... by quantaman · 2015-07-08 06:29 · Score: 1
  
  I can tell you that as just an office worker, I get PISSED when my co-worker comes in with a cough, I know I will end up getting it.
  People will still feel guilty calling in sick when capable of working.
  
  I think this is one aspect of poor management., Management sets the tone - do they complain etc. when you call in sick? If they don't, then people take off when they are sick.
  It is truly a shame that hospital management is so penny-wise/pound foolish as not to insist on generous sick time.
  I think it's more than complaining, management needs to actively encourage people who are mildly sick to take the day off and to actively sell it as being good for the company. Otherwise people will feel like they're shirking their duty.
  I think my current organization is particularly bad in this regard as they pay only 50% for sick days, so if people are remotely capable of working they'll come in so they don't take the hit.
  
  --
  I stole this Sig
38. Re:As a physician... by Anonymous Coward · 2015-07-08 07:53 · Score: 0
  
  As the page itself describes, that's really a ranking of incomes, converted to IQ scores.
  The theory is that there's a known average mapping of IQ to income and a known mapping of career to average income, so combine those to map career to average IQ.
  There are obvious built-in flaws -- IQ is probably not comletely independent of either income or career, but it's not totally determinative either.
39. Re:As a physician... by AK+Marc · 2015-07-08 08:29 · Score: 1
  
  He's already a member (presumably a registered doctor in the US), the AMA. That's a labor union.
  
  --
  Learn to love Alaska
40. Re:As a physician... by PopeRatzo · 2015-07-08 08:37 · Score: 1
  
  Except God didn't; man did.
  
  Pope Leo XIII, Pope John Paul II, Pope Benedict XVI and Pope Francis would disagree with you. But you would probably know more about God than those losers, right?
  http://w2.vatican.va/content/l...
  https://en.wikipedia.org/wiki/...
  http://www.usccb.org/upload/Pr...
  
  And labor unions would not necessarily make things much better. Many nurses work for under a union, and it tends to create the "well, it's not my job to do X" mentality, because if you're in a union and you do your job but could have done X that is Jane's or Joe's job then you get penalized despite it being faster for you to do it than calling Joe or Jane to do so.
  You've never been in a labor union have you?
  
  It's also why it costs $19 to get an aspirin in the hospital.
  I'm sorry, but that's just bullshit. You think the hospital's markup on drugs is because of the unions?
  https://web.williams.edu/Econo...
  
  --
  You are welcome on my lawn.
41. Re:As a physician... by PopeRatzo · 2015-07-08 08:42 · Score: 1
  
  He's already a member (presumably a registered doctor in the US), the AMA. That's a labor union.
  Less than a quarter of all doctors in the US are members of the AMA.
  
  --
  You are welcome on my lawn.
42. Re:As a physician... by david_thornley · 2015-07-08 08:45 · Score: 1
  
  I've actually never worked a job where I had to schedule my major auto accidents a week before, personally, and in fact I didn't give my employer even a day's advance warning of my heart attack.
  If it's that vitally important that you are at your job, somebody has screwed up big time. One of these days you will simply not be there, for some reason or other.
  
  --
  "When you have eliminated the unacceptable, whatever is left, however improbable, must be the truthiness" - Holmes
43. Re:As a physician... by TemporalBeing · 2015-07-08 10:26 · Score: 1
  
  It's also why it costs $19 to get an aspirin in the hospital.
  I'm sorry, but that's just bullshit. You think the hospital's markup on drugs is because of the unions?
  Not directly no. It basically goes like this: Union regulations require that the certain members can administer medications.
  CFOs dictate that they charge for those people's time, but to increase the bill they break out each medication separately. So the nurse that is there to administer 5 medications gets to charge up the time 5x's (once for each medication). So if it took 5 minutes to administer the medication, the result is a 25 minute charge.
  Now, unions influence which members (RN vs regular, but qualified, nurse) can administer the medications thereby influencing the cost of the medication through the time allocation since the hospital has no choice but to use more expensive staff to administer the medication.
  
  Now, I'd first want to outlaw that the person administering the medication gets to charge their time 5x's over for administering the 5 drugs. In fact, I'd even go so far as to say that they don't get to charge their time to the patient at all, only the cost of the medication. This would mean they would only be able to charge $0.05 (or less) for that aspirin.
  
  Is the nurse's or doctor's time worth something? Yes, but it's part of the basic services provided by the hospital, and should be included in the daily "hospital stay" charge, or as part of the cost of certain procedures (e.g surgery) as a flat cost for the procedure. So your "hospital stay" portion of the bill would be closer to $150/day instead of $60/day; but you wouldn't get charged for the 50 times the various staff/nurses/doctors/etc come in to check on you, provide medication, etc during that time period - so $60/day + $19/aspirin*6/day would be more expensive in the end than the basic stay bill.
  
  And I'm not pulling the cost of $19 for an aspirin out of thin air either - the number is from a Dateline or 20/20 news report in the 1990's; meaning, it's likely a lot higher now (at the very least due to inflation, if not also medical costs), and that's only what Medicare/Medicaide paid.
  
  The reason it costs that much is a systemic issue; solve that actual issue and you'll solve a lot of the health care cost issues. Only part of that issue is related to unions, but it still is a significant factor.
  
  --
  Truth is like the sun. You can shut it out for a time, but it ain't goin' away. - Elvis Presley (source: imdb.com)
44. Re:As a physician... by PopeRatzo · 2015-07-08 12:25 · Score: 1
  
  Not directly no. It basically goes like this: Union regulations require that the certain members can administer medications.
  CFOs dictate that they charge for those people's time, but to increase the bill they break out each medication separately. So the nurse that is there to administer 5 medications gets to charge up the time 5x's (once for each medication). So if it took 5 minutes to administer the medication, the result is a 25 minute charge.
  Now, unions influence which members (RN vs regular, but qualified, nurse) can administer the medications thereby influencing the cost of the medication through the time allocation since the hospital has no choice but to use more expensive staff to administer the medication.
  
  What percentage of a hospital's expenses are made up by total labor costs? Go ahead, take a guess.
  Now take a guess at the differential between the bill presented to a patient paying their own bill and an insurance company.
  
  The reason it costs that much is a systemic issue; solve that actual issue and you'll solve a lot of the health care cost issues. Only part of that issue is related to unions, but it still is a significant factor.
  You make a lot of the $19 that a patient is charged for an aspirin. How much do you think the average nurse makes, and do you believe it is too much? Do you also believe doctors are overpaid? Do you also believe the corporations that run for-profit hospitals are making too much profit?
  You mistake the price a corporation charges for a service with the cost of the labor for providing that service. You try to put the exorbitant cost of health care on the people who are providing that care, when in fact, the most expensive parts of health care are impacted barely at all by labor.
  
  --
  You are welcome on my lawn.
45. Re:As a physician... by Anonymous Coward · 2015-07-09 02:46 · Score: 0
  
  Are your management ignorant of the "bus factor"? If not ignorant, they should really have processes in place to deal with the bus factor. This sounds like a real shitstorm waiting to happen.
46. Re:As a physician... by TemporalBeing · 2015-07-09 03:36 · Score: 1
  
  You make a lot of the $19 that a patient is charged for an aspirin. How much do you think the average nurse makes, and do you believe it is too much? Do you also believe doctors are overpaid? Do you also believe the corporations that run for-profit hospitals are making too much profit?
  You mistake the price a corporation charges for a service with the cost of the labor for providing that service. You try to put the exorbitant cost of health care on the people who are providing that care, when in fact, the most expensive parts of health care are impacted barely at all by labor.
  There are a lot of facets to the costs of health care, and the biggest cost is actually having insurance to start with. Doctors that have started refusing insurance (of all kinds) have reduced overhead costs by 66% just from the lack of having to do all the paperwork, the filing and refiling in order to get paid, that goes along with accepting insurance.
  
  There are other costs too, some of which are brought on by unions, some by insurance, some by suppliers. They all need to be reigned in.
  
  You don't save by cutting only the biggest costs. You save by cutting all costs - by monitoring each penny, instead of by the dollar, tens of dollars, etc - by making each penny (per accounting terms) material.
  
  --
  Truth is like the sun. You can shut it out for a time, but it ain't goin' away. - Elvis Presley (source: imdb.com)
47. Re:As a physician... by Drethon · 2015-07-09 03:49 · Score: 1
  
  They are less concerned with those hit by a bus and more concerned with the cost of hiring enough people to get the job done. Not to mention that qualified DO-178b software engineers are a limited supply and training new people is not the preferred approach.
Title is stupid by Anonymous Coward · 2015-07-07 12:56 · Score: 5, Insightful

While it is true that there are doctors working while they themselves are not feeling well, you guys gotta understand that doctors have to face sick people ALL THE TIME, which means they have higher chance of getting infected with diseases, which means they have to spend more times feeling unwell
It is always so easy to criticize someone of doing something but why is it there is no mention of what makes that someone do that something in the first place?
1. Re:Title is stupid by Actually,+I+do+RTFA · 2015-07-07 16:46 · Score: 5, Insightful
  
  That just seems to imply that doctors shouldn't be trained to work stupid-long immune system destroying hours, should be overstaffed (not understaffed) to allow for frequent sick days, etc. In other words, double the number of medical schools, reduce the on-call stress that hurts the immune system and reform the residency system. Maybe also get rid of the concept that doctors are so much smarter/more honorable than the poluace instead of just having a different skillset.
  Medicine is pretty poorly done in, well, the US. Maybe the whole world, but I have no idea how other countries train doctors.
  
  --
  Your ad here. Ask me how!
2. Re:Title is stupid by DNS-and-BIND · 2015-07-08 00:20 · Score: 0
  
  Whaaa?? Medicine is poorly done in America? You're joking, right? America has some of the best doctors in the entire world. The medical schools are full of foreigners who come to train and then go back to their home countries. An American medical school diploma is worth a lot back there. Everyone knows you can't just buy one the same way you can with the medical diplomas in their country. Maybe you're just an anti-American bigot, and as we know bigotry and ignorance are always found together.
  Doctors *are* smarter. They have to be. You won't find many double-digit IQs because they don't make it out of undergraduate study.
  
  --
  Shutting down free speech with violence isn't fighting fascism. It IS fascism!
3. Re:Title is stupid by Actually,+I+do+RTFA · 2015-07-08 04:17 · Score: 1
  
  America has some of the best doctors in the entire world
  You're conflating the best individual care with the system. Imagine two countries, both with a billion people (for shits and giggles). One has up and running, I dunno, like a million doctors. The other has exactly one of those machines from Elysium that autocures someone in five minutes. Which has the best system?
  Well, to those people able to get into the machine, I'm guessing they would say the Elysium-like one. But to society as a whole? The million doctors.
  
  he medical schools are full of foreigners who come to train and then go back to their home countries.
  We should put a stop to that. We need those slots for Americans who will practice in America.
  
  Doctors *are* smarter. They have to be. You won't find many double-digit IQs because they don't make it out of undergraduate study.
  Currently, 30% of the population gets an undergraduate degree. Doctors aren't necessarily stupid, but there are lots of careers for smart people. And most medicine doesn't require a world-class mind. It's a waste to use a great brain in a away that does not scale.
  
  --
  Your ad here. Ask me how!
4. Re:Title is stupid by AK+Marc · 2015-07-08 08:37 · Score: 1
  
  The studies on humans show we work best with a 6 hour shift. When there are no external factors (no stores to shop at, no sun to set a clock), humans work best with even shorter work times. 3 hours on, 3 hours off will get more working hours in a day, and they'll be higher quality hours. Though that only works in a place like a submarine, where you have food and sleep 30 seconds from work. A 1 hour commute would break the 3/3 schedule.
  
  We stick to the past, even when the past is proven wrong. We shouldn't be working 8-10 hour days. We don't even need 8 hours uninterrupted sleep. But we work off that schedule because it's convenient.
  
  --
  Learn to love Alaska
What's worse? by brian.stinar · 2015-07-07 12:57 · Score: 5, Informative

"More than 95 percent believed that working while sick puts patients at risk, but 83 percent still said they had come to work with symptoms like diarrhea, fever and respiratory complaints during the previous year."
I think that 100% would believe that not seeing a doctor would put the patient at GREATER risk. Maybe in London (where Reuters is based) there are enough doctors working for the central government mandated health industry that sick doctors don't feel the pressure to come in. However, it looks like in Philadelphia (where the data was collected) there aren't enough doctors. I know that my medical doctor friends go to work sick, since the risks associated with someone catching a cold is much greater than the risks associated with not seeing a medical provider. In some places in rural New Mexico, you get to drive for 2+ hours to see a similar specialist. My urban Albuquerque isn't as bad, but things are still pretty backed up and doctors usually schedule months in advanced for routine things.
1. Re:What's worse? by catsRus · 2015-07-07 13:13 · Score: 1
  
  True, one can get a lot of their medical education for free if you contract to work in the rural areas here in NM for X amount of years after your residency.
2. Re:What's worse? by jeff13 · 2015-07-07 13:47 · Score: 1
  
  Sooo, it's American doctors. This study is new, and I'm not aware of studies for countries like England and Canada that have social healthcare, but I gotta wonder if that's a factor.
3. Re:What's worse? by jeff13 · 2015-07-07 13:49 · Score: 2
  
  oops... http://www.cbc.ca/news/health/...
4. Re:What's worse? by Anonymous Coward · 2015-07-07 13:54 · Score: 1
  
  I think that 100% would believe that not seeing a doctor would put the patient at GREATER risk.
  Many doctor visits (probably actually the majority) are unnecessary and put you at risk of both infection and medical error.
5. Re:What's worse? by Anonymous Coward · 2015-07-07 14:29 · Score: 0
  
  Mod parent up, please. I have no mod points today.
6. Re:What's worse? by ArcadeMan · 2015-07-07 14:49 · Score: 1
  
  Yeah, but Canadian doctors are spreading free infections.
  
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7. Re:What's worse? by Aqualung812 · 2015-07-07 18:03 · Score: 1
  
  I think that 100% would believe that not seeing a doctor would put the patient at GREATER risk.
  I agree, but this article just lowered the trust people have in doctors, reducing the number of people that will actually go see a doctor.
  
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  Grammer Nazis - I mod you "troll" unless you actually add something on-topic. Yes, I know I have mispellings in my sig.
8. Re:What's worse? by techno-vampire · 2015-07-07 18:44 · Score: 1
  
  New Mexico isn't the only state that's done this kind of thing. At one time, so was Alaska.
  
  --
  Good, inexpensive web hosting
9. Re:What's worse? by Dr_Barnowl · 2015-07-07 21:20 · Score: 1
  
  Just anecdotally, my ex-wife (a paediatric oncologist) considers the only real excuse for not working to be "death". Although I imagine she does actually take time off if she's infectious, because many of her patients have a weakened immune system.
  I don't think it's something limited to doctors. In the States, where you have a lot of "at will" employment contracts and can be fired without reason, I'm sure that many people work when they are sick just because they are afraid to get the sack.
sick days equal fired days by turkeydance · 2015-07-07 12:57 · Score: 0, Flamebait

in the USA, anyway.
1. Re:sick days equal fired days by jellomizer · 2015-07-07 13:15 · Score: 1
  
  That is bit of an exaggeration.
  In most professional environment I have worked at sick days are not frowned at. However in areas where there is less skilled labor it could get you in trouble as it is often used as excuse to get out of work.
  
  --
  If something is so important that you feel the need to post it on the internet... It probably isn't that important.
2. Re:sick days equal fired days by Anonymous Coward · 2015-07-07 13:18 · Score: 0
  
  And this is true in most other professions now. I have sick days built into my contract, but using them would be something similar to heresy.
3. Re:sick days equal fired days by turkeydance · 2015-07-07 13:18 · Score: 1
  
  until you are fired.
4. Re: sick days equal fired days by Anonymous Coward · 2015-07-07 13:50 · Score: 2, Informative
  
  Maybe a little exaggerated, but not entirely. I work in technology, same employer for nearly 16 years, and we get PTO instead of vacation/sick time. Company policy is that you can take your PTO whenever you like for any reason (or no reason at all).
  I've been dinged severely for "taking too much unplanned PTO" on performance reviews. In addition, my boss one year negatively called out a "lengthy unplanned absence", despite the fact that I was in the hospital after having a heart attack.
5. Re:sick days equal fired days by Khyber · 2015-07-07 14:27 · Score: 0
  
  How the fuck is this flamebait? Must be some employers running around with mod points, today. Perhaps even Slashdot owners.
  
  --
  Still waiting on Serviscope_minor to wake up to fucking reality and realize that Jessica Price isn't going to fuck him.
6. Re: sick days equal fired days by Anonymous Coward · 2015-07-07 18:50 · Score: 0
  
  "In the future, I swear to plan my heart attacks to better coincide with company objectives." Yea, same problem in factory work as well. Although from my experience as a "temp" who has been there for years, the fact is that even hiring enough, quality temps is too much of a burden for management (no real idea who/what is the cause and whether it's more the temp agency or the company that's at fault). Although that goes hand-in-hand with underpaying temps relative to full-timers and generally trying to skimp on the number of temps while simultaneously limiting what temps can do (meaning they can't effectively be floaters when people do call in sick). In fact, it's overall more absurd precisely because it's non-creative work with overall lower pay and generally a lot more flexibility to introducing more people to solve production issues. Yet instead the focus seems to be more about voluntary/mandatory overtime and pushing people on different shifts for short bursts to compensate for production issues and to allow people to pad their paycheck as desired. Honestly, the whole mentality that "plenty of available overtime" is a "positive" is still very insane to me.
7. Re: sick days equal fired days by Dr_Barnowl · 2015-07-07 21:23 · Score: 1
  
  plenty of available overtime" is a "positive"
  
  It's a sign that you're not being paid enough. Despite the overwhelmingly positive public opinion that any family with a full-time worker should not be in poverty and be comfortable, it isn't true.
Economic value by manu0601 · 2015-07-07 13:04 · Score: 2

If a doctor contaminates patients, then the economic value of his work day is probably negative.
I noted the point of high workloads, but it just suggests that we need more doctors, and that subsiding would make sense.
1. Re:Economic value by hcs_$reboot · 2015-07-07 13:10 · Score: 1
  
  If a doctor contaminates patients, then the economic value of his work day is probably negative.
  Not purely negative. The doctor exposes his patients to some germs and have them create the appropriate antibodies. That's immunization!
  
  --
  Slashdot, fix the reply notifications... You won't get away with it...
2. Re:Economic value by manu0601 · 2015-07-07 13:42 · Score: 2
  
  The doctor exposes his patients to some germs and have them create the appropriate antibodies. That's immunization!
  Except that the patient is likely to be already sick, and it is not the best time to introduce new germs.
3. Re:Economic value by Anonymous Coward · 2015-07-07 14:28 · Score: 0
  
  > the economic value of his work day is probably negative.
  True, but for himself he has created economic value from the large bills he gets to create, and even more from the next round of bills after some of the patients he sees get sick. Despite the fact they're almost all Republicans so they do this because they're greedy, it does make sense for the doctor to create more business for himself like this.
4. Re:Economic value by xanthines-R-yummy · 2015-07-08 00:20 · Score: 1
  
  You clearly have a different idea of what economic value means versus hospital admins and department chairs. Look up the concept of RVU's and you'll see why coming in to work, no matter what, will continue (because it is economically incentivized). Only a TREMENDOUS amount of social change will overcome that.
  Check out this thread...
  http://forums.studentdoctor.ne...
  Yes, I'm a physician in real life and yes, this mentality disgusts me.
5. Re: Economic value by sabbede · 2015-07-08 05:23 · Score: 1
  
  Given the choice between catching something and bleeding to death from a compound fracture, I'll happily catch whatever the doctor has.
6. Re: Economic value by sabbede · 2015-07-08 05:27 · Score: 1
  
  We don't need "tremendous social change". We need more doctors. That solves every problem in the healthcare system.
7. Re: Economic value by manu0601 · 2015-07-08 12:44 · Score: 1
  
  Sure, but this is a personal choice within a suboptimal set of outcomes. Decisions at the political level are about collectively improve the set of personal choices. This is what I was talking about.
8. Re: Economic value by sabbede · 2015-07-14 23:56 · Score: 1
  
  Ah, I take your point. Going back to the beginning of the thread, you hit a far more important nail on the head. The root of the cost problem in the US healthcare system! Simple supply and demand - there aren't enough doctors to satisfy demand, so costs are naturally high. And we consistently make the problem worse by focusing not on increasing supply, but rather subsidizing (aka increasing) demand.
  There's also an improper focus on how we pay for healthcare. Because European nations with single payer or nationalized healthcare have lower costs, people assume adopting one of those systems will solve the cost problem here. What they don't take into account is that those nations have 50-100% more doctors and hospital beds per patient. I came across (and lost) a fascinating historical study of healthcare in the US illustrating how throughout the 20th century a number of measures were put in place to restrict the supply of doctors and hospital beds. At least up to the 60's, when the focus shifted to subsidizing demand.
  I agree that subsidizing medical training would be a move that would actually help, graduating with a quarter-to-half million dollars in debt is not exactly an incentive, but there's another problem. There aren't enough medical schools to train all the doctors we need. Less than half of well qualified applicants to med school can actually get in to a program. Also a legislative cock-up. It's nigh impossible to start a new med school. Even if a university want's to start one, odds are that the AMA won't let them, Nor can we import doctors, as the AMA won't certify graduates of foreign training programs. If a doctor wants to immigrate, they aren't allowed to practice unless they go through an American medical program and redo their residency.
9. Re: Economic value by manu0601 · 2015-07-15 12:24 · Score: 1
  
  AMA won't let them
  Well, AMA is neither the Sovereign, nor even the legislator...
10. Re: Economic value by sabbede · 2015-07-16 01:10 · Score: 1
  
  Oh, I know, it's whats called a "Self-Regulatory Organization". Congress gave them sole authority for accreditation of medical professionals. University programs are accredited by the Liaison Committee on Medical Education, which is run by the AMA and the Association of American Medical Colleges, and likewise recognized by Congress as the sole authority on the matter.
  As far back as 1977 there were concerns that the AMA and LCME were intentionally restricting the supply of doctors ( http://www.washingtonpost.com/... ). Which went nowhere.
Doctors always know best by Okian+Warrior · 2015-07-07 13:15 · Score: 1

While it is true that there are doctors working while they themselves are not feeling well, you guys gotta understand that doctors have to face sick people ALL THE TIME, which means they have higher chance of getting infected with diseases, which means they have to spend more times feeling unwell
It is always so easy to criticize someone of doing something but why is it there is no mention of what makes that someone do that something in the first place?
Because doing so implies that it's OK because it has a justification. "Hey, it's OK for doctors putting us at risk, because they have a really good reason".
This is a clear-cut example of that "needs of the many" thing. Yes, doctors encounter sickness more often then average. Yes, that probably means they get sick more often. Yes, their work is really hard.
Does the inconvenience of one doctor outweigh the inconvenience of 5 patients catching what he's got?
I once read a study where doctors refuse to use checklists, despite abundant evidence that doing so would reduce the incidence of hospital errors.
The reason? Doctors simply didn't want to use them - they felt that they were good enough not to need them.
(That was awhile ago - now checklists are starting to catch on.)
1. Re:Doctors always know best by dbIII · 2015-07-07 14:36 · Score: 3, Insightful
  
  Pilots don't want to use checklists either, but they put up with it because the checklists are written by other pilots and not HR folk, administrators or medical students given a task because everyone else is too busy.
  It is slowly happening in some areas (trauma medicine) because it's being done well and being rejected in others because it is not.
2. Re:Doctors always know best by FlyHelicopters · 2015-07-07 16:02 · Score: 4, Informative
  
  Pilots don't want to use checklists either
  Nonsense... a good pilot WANTS to use a checklist, the cockpit tends to reach the site of a crash first...
  Humans are not perfect, more than once I've missed something trying to do it from memory or seen someone else do it, including high time experienced pilots.
  A good training program will weed out the "I've got it, I've got it" attitude... No, no you don't... use the checklist...
  Modern aircraft are too complicated to have it all perfect in your head every time, 100% of the time, in any situation. You should know your checklists and you should practice with them, but you should still pull them out and use them.
3. Re:Doctors always know best by Anonymous Coward · 2015-07-07 20:48 · Score: 0
  
  A good training program will weed out the "I've got it, I've got it" attitude... No, no you don't... use the checklist...
  One question which comes to mind, though, is whether memory items count as checklists. That is, small "checklists" of important items which need to be done so fast that pilots are supposed to have them memorized. I learnt this from reading about the AF447 investigation - just one of the shortcomings of that criminally incompetent crew was not remembering or at least not performing the memory item for "airspeed disagree".
4. Re:Doctors always know best by Bearhouse · 2015-07-07 21:03 · Score: 1
  
  Totally agree - many accidents have been cause by pilots not reading their checklists.
  As the saying goes, "all airplanes kill stupid pilots".
5. Re:Doctors always know best by Anonymous Coward · 2015-07-07 22:56 · Score: 0
  
  I know too many pilots to believe this is true.
  The number one cause for small craft going down is a failure to check the fuel level prior to take off. Flight safety is drilled into the pilot with training at every opportunity, and the mentality is "if it isn't checked, it's broken and will kill you". That's not a bad place to begin at, considering you don't have the liberty of pulling over and dealing with issues on terra firma.
6. Re:Doctors always know best by djbckr · 2015-07-08 03:23 · Score: 1
  
  Pilots don't want to use checklists either
  Bullshit. A pilot that doesn't use a checklist is going to be a dead pilot. And if he/she has passengers, they will die too. There's a reason for the checklist: So you don't kill yourself and others.
7. Re:Doctors always know best by FlyHelicopters · 2015-07-08 05:36 · Score: 1
  
  One question which comes to mind, though, is whether memory items count as checklists.
  They do...
  However you're supposed to know those by heart, front to back, but then you double check them from the checklist.
  So an emergency response checklist might have 30 items on it, the first 6 of which are "memory items", meaning you should know them 100% perfectly.
  This is done because an aircraft might have more than a dozen checklists, it is not reasonable to expect humans to memorize 100% of all of them, but for perhaps 5 of them, the first 5 or 6 items, you can expect every single pilot to know those 30 or so lines by heart.
  However, after you have performed those items, you're supposed to pull out the checklist and double check that they have been done.
  For example, there is an engine fire checklist. The first few items on there need to be done right away. If the fire light goes off, you need to respond right away, not in a min after you've pulled out and read the checklist.
  ---
  The real problem with checklists is not the "engine fire" checklist. I don't know any pilots who would fail to use a checklist in that situation, but I'm sure they exist.
  It is the normal takeoff and landing checklists, the routine ones they have done a thousand times, that get ignored.
8. Re:Doctors always know best by dbIII · 2015-07-08 12:12 · Score: 1
  
  Do I have to give English lessons? It's annoying paperwork they may not want to do, but they know it's a very good idea so they do it anyway. It's just like not wanting to brush your teeth.
AND HOW THE FUCK DOES THIS MATTER? by Anonymous Coward · 2015-07-07 13:22 · Score: 0

Nerds often sick, are they?
You're sick! You're sick!
Engineer Solution by Korbeau · 2015-07-07 13:25 · Score: 1

Prioritize the patient queue based on similar symptoms.
This is true. by AndyKron · 2015-07-07 13:38 · Score: 2

My dad is a pediatrician (retired), and this is true.
1. Re:This is true. by Anonymous Coward · 2015-07-09 05:22 · Score: 0
  
  Your father knowingly infected children. Jesus...
does it matter? by NostalgiaForInfinity · 2015-07-07 13:47 · Score: 2, Interesting

Doctors' offices and hospitals are full of people who carry infections. You already have a high chance (probably around 30%) of coming out with an additional disease to the one you went in with, both from transmission from other patients, and through medical error. One more sick person (the doctor himself) hardly makes a difference.
1. Re:does it matter? by Anonymous Coward · 2015-07-07 15:12 · Score: 0
  
  Ah - you want to think about that a bit more.
  That one sick doctor is different in that they are making close and persistent contact with the patients they are treating. They are more of a risk than the sick person in the bed in the next ward.
Everybody works while sick by fustakrakich · 2015-07-07 13:52 · Score: 1

Our entirely sociopathic economic system demands it. Poor health and death are no excuse!

--
“He’s not deformed, he’s just drunk!”
You need crappier doctors by penguinoid · 2015-07-07 14:06 · Score: 5, Interesting

Seriously, if there aren't enough doctors it doesn't matter how good they are, enjoy waiting a month to get emergency* treatment from an overworked doctor who's only going to spend 5 minutes with you. If you drastically reduce the requirements for becoming a doctor, then you'll get prompt treatment from a well-rested doctor who can afford to spend a good long while with you and still charge you less. Sure, they'll make some mistakes... but so do current doctors. Requiring less training might actually reduce the number of mistakes. Especially if the mistakes were of the class of waiting too long due to busy schedules, patients avoiding the hassle, doctors going to work sick/tired, or any of the various effects of not enough doctors.
* there's some conditions that are serious enough that you ought to receive immediate treatment, but don't officially qualify as emergencies.

--
Don't waste your vote! Vote for whoever you want, unless you live in a swing state it won't matter anyways
1. Re:You need crappier doctors by Anonymous Coward · 2015-07-07 14:34 · Score: 1
  
  That's why most U.S. Healthcare systems are preferring to hire Physician Assistants or Nurse Practitioners instead of physicians: we're about 50% cheaper, easier to train, have most of the same education, and can cover the vast majority of routine care. You absolutely need SOME physicians to run the show and handle the most serious and complex cases, but the routine work can be done faster, cheaper, and substantially as well by PAs or NPs. In fact, some research shows they may actually be better than residents:
  http://journals.lww.com/ccmjournal/Citation/2014/12001/49___ICU_OUTCOMES_OF_PHYSICIAN_ASSISTANTS_AND.52.aspx
2. Re: You need crappier doctors by Anonymous Coward · 2015-07-07 15:15 · Score: 0
  
  Out just go to a "Doc in a box" like at CVS or Walgreen's. In and out quick and with the prescription filled onsite -- I suspect these are PAs or NPs seeing the patients.
3. Re:You need crappier doctors by NostalgiaForInfinity · 2015-07-07 17:04 · Score: 0
  
  If you drastically reduce the requirements for becoming a doctor,
  The requirements are so high because of AMA lobbying: they keep them that way, limit medical schools, and make sure that patients must see physicians even for problems that could be addressed by nurses or pharmacists. Meaning, what we have is this way because government wants it to be this way.
  (Europe has a complementary problem: price controls on medical care keep physician salaries down, making the job unattractive compared to jobs with comparable salaries but less risk and less stress.)
4. Re:You need crappier doctors by Dahan · 2015-07-07 19:11 · Score: 1
  
  The requirements are so high because of AMA lobbying: they keep them that way, limit medical schools, and make sure that patients must see physicians even for problems that could be addressed by nurses or pharmacists.
  What kinds of problems are those? As far as I know, patients can see nurses for minor problems that can be addressed by nurses (specifically nurse practitioners). The clinics in pharmacies and supermarkets (e.g., CVS Minute Clinic, Walgreen's Healthcare Clinic, The Little Clinic, Rediclinic) are generally staffed by nurse practitioners and physician assistants.
5. Re:You need crappier doctors by Anonymous Coward · 2015-07-07 23:19 · Score: 0
  
  ... have most of the same education,...
  bahahahahahahahahahaha.
6. Re:You need crappier doctors by Anonymous Coward · 2015-07-08 00:00 · Score: 0
  
  That's why most U.S. Healthcare systems are preferring to hire Physician Assistants or Nurse Practitioners instead of physicians: we're about 50% cheaper, easier to train, have most of the same education, and can cover the vast majority of routine care. You absolutely need SOME physicians to run the show and handle the most serious and complex cases, but the routine work can be done faster, cheaper, and substantially as well by PAs or NPs. In fact, some research shows they may actually be better than residents:
  http://journals.lww.com/ccmjournal/Citation/2014/12001/49___ICU_OUTCOMES_OF_PHYSICIAN_ASSISTANTS_AND.52.aspx
  More importantly, their schools aren't capped and controlled by the American Medical Association, that political lobbying group that says you can only practice in the USA if they approve you, you can only become a Physician if you go to one of their approved schools, and they can control the number of entrants, to ensure quality. While quality control is important, this has the side effect of making doctors scarce, which drives up the cost per Physician. By the time a Physician could theoretically solve the problem (by the time they get enough power to be on an AMA board) they are part of the problem and don't want to undermine their own profession. They want to cash out on a system that is designed to be stable with a high initial cost, high cost of entry, and very high rate of late return.
7. Re:You need crappier doctors by Anonymous Coward · 2015-07-08 01:04 · Score: 0
  
  What price controls? You can charge as much as you want for your services in Europe (at least in this part of europe). The percentage of people actually getting to training of everyone who wants to be a doctor and who applied is around 10%. The ones who realised they don't have a chance of getting a perfect admission score have dropped out before these numbers. There is absolutely no way of simply buying yourself in, you have to study VERY hard to get admitted.
8. Re:You need crappier doctors by NostalgiaForInfinity · 2015-07-08 01:35 · Score: 1
  
  As far as I know, patients can see nurses for minor problems that can be addressed by nurses (specifically nurse practitioners)
  Correct, and medical associations generally have been trying to limit expansion, for example trying to limit NPs to operating only under a doctor's supervision.
9. Re:You need crappier doctors by Anonymous Coward · 2015-07-08 02:27 · Score: 0
  
  Christ, you don't have 'the same education'. You get less than half the didactic training of MD / DOs and almost none of the serious clinical training. NPs / PAs are great in certain well defined areas where they can get enough on the job experience but they are not replacements for physicians. The fact that you think you understand what the 'vast majority of routine care' is means that you don't know what you don't know. And that is very, very dangerous.
  Get some humility buster. You aren't as smart as you think you are.
If your hospital does not encourage wellness by Khyber · 2015-07-07 14:19 · Score: 0

You can guarantee I'll just sit at home to recover, instead. Fuck your profit scheme designed to have doctors make you money by working when they should not be working.

--
Still waiting on Serviscope_minor to wake up to fucking reality and realize that Jessica Price isn't going to fuck him.
Career issues by dbIII · 2015-07-07 14:20 · Score: 1

Turning up while sick is not good at getting the job done but it keeps them in a job.
So in other words... by bananaquackmoo · 2015-07-07 14:42 · Score: 2

Exactly like every single other profession? Seriously. Name one job which doesn't encourage you to go in to work even when you are sick.
1. Re:So in other words... by Anonymous Coward · 2015-07-07 15:20 · Score: 0
  
  Air traffic controller, Astronaut, (any food service) you may be encouraged but you're not supposed to work if you're suffering from a transmittable bug, Fighter Pilot, Bodyguard (close protection), Buckingham palace guard, swiss guard....
2. Re:So in other words... by Anonymous Coward · 2015-07-07 15:22 · Score: 0
  
  Uh.. how about software development?
3. Re:So in other words... by Taco+Cowboy · 2015-07-07 15:38 · Score: 1
  
  Seriously. Name one job which doesn't encourage you to go in to work even when you are sick
  
  The Capitol Hill!!
  But wait ... they are all sick to the core to begin with !!
  
  --
  Muchas Gracias, Señor Edward Snowden !
4. Re:So in other words... by tsqr · 2015-07-08 02:20 · Score: 1
  
  Exactly like every single other profession? Seriously. Name one job which doesn't encourage you to go in to work even when you are sick.
  Uh... every job I've ever had for the past forty years. Management at every place I've ever worked has been far more likely to berate an employee for showing up with symptoms than for taking sick days.
5. Re:So in other words... by Anonymous Coward · 2015-07-09 05:24 · Score: 0
  
  But they are in the rather unique situation of working with people every day who have compromised immune systems.
It's expected by JazzHarper · 2015-07-07 14:59 · Score: 4, Insightful

This is the work ethic that is pounded into residents and interns.
You MUST work, regardless of sleep deprivation, personal trauma, or contagious illness.
(That is why I became an engineer, rather than a doctor like my father and my grandfather.)
1. Re:It's expected by Moof123 · 2015-07-07 16:07 · Score: 5, Insightful
  
  Medical school hours and conditions looks like a giant hazing ritual. Plenty of science shows it is dumb and make all mortal humans more error prone. Somehow the medical profession thinks they are super-human (or must act as if they are) and put their patients in increased danger from fatigue and apparently illness as well.
  Listening to an NPR piece on residency some months back sounded really pathetic. The pervasive attitude was that it made you a better doc, and since everyone else went through it then I have to too. Someone needs to get through that the emperor has no clothes and this is just stupid.
  In the end my experience with docs is they are all pretty darn human, and all this hazing and stupid over-work ethic does nothing more than give them a false sense that they are not.
2. Re:It's expected by AthanasiusKircher · 2015-07-07 20:31 · Score: 3, Informative
  
  Listening to an NPR piece on residency some months back sounded really pathetic. The pervasive attitude was that it made you a better doc, and since everyone else went through it then I have to too. Someone needs to get through that the emperor has no clothes and this is just stupid.
  This is certainly true. Although they don't like to admit it, the medical field is full of a lot of "lore" that has never really been tested scientifically to produce better results. From the residency hazing to the whole "white-coat ceremony" weirdness, becoming a doctor still has some of the odd trappings of entering into a medieval cult or something.
  The problem is that deviating from past tradition is seen as inherently risky for people who deal with "life and death," so whether it's changing training routines or questioning some standard clinical practice, it's really hard to change things... which is one of the reasons for the rise in so-called "evidence-based medicine" in recent decades. I know we all want to believe that medicine is scientifically rigorous, but there are often severe obstacles to achieving scientific rigor once a practice has caught on in the medical profession -- because refusing the "standard treatment" might be unethical, even if that treatment was adopted after uncontrolled non-randomized tests that had statistically questionable success.
  I have great respect for doctors, who generally work hard and care greatly about their patients. But the profession and practice is severely broken and weighed down with bizarre (even mystical) baggage about how better doctors come from weird crap... like the hazing and long hours.
3. Re:It's expected by swb · 2015-07-07 23:46 · Score: 1
  
  I can't help but think that the medical system feels something like a mix between an aristocracy and a cartel.
  On one hand, it seems very much a class-based system. Doctors aren't involved in a lot of hands on medical practice, they get nurses to do a lot of it. Is this a specialty based division of labor, or is it a remnant of a class system from a couple of centuries ago where doctors were likely to be members of the social elite from birth?
  On the other hand, there seems to be a lot of cartel like structure that's designed to limit competition. Filtering structures in training and education serve to limit who gets into medical school and who is able to finish residency. And by limiting the number of people who can be doctors, you are able to justify a class based labor system, high wages, etc.
  Then there's the actual practice of medicine, where only doctors are allowed to do a fairly wide number of medical tasks or have to be involved in supervising non-doctors whose training would seem to make them reasonably qualified to do on their own.
  Another poster in the comments suggested we need more, less well trained doctors. That's probably reasonable. Other than an emergency surgery I had a couple of years ago, I can't think of much of my exposure to the medical practice that couldn't have been met just fine by a nurse practioner or physician's assistant. Sure, we probably need the specialists and people with advanced education for diagnoses and speciality care -- your level 2-3+ ticket escalation -- but it seems like for the majority of ailments and regular care, a doctor is simply overtrained and underavailable.
  And what about pharmacists? They have doctor-like training yet for the most part don't seem to do very much but count pills. Sure, they serve as a safety net in some regards to make sure that people who take a constellation of medications don't end up with complications from contraindications and side effects, but that's limited to a person getting all their prescriptions filled by one pharmacy, which is habit people have, not a requirement.
  If you think about it, even with the class-based structure of medical practice, today's physician assistants and nurse practitioners are probably better trained and more informed than most general practioners were 50 years ago. It's not hard to see why it wouldn't make sense to have PAs and NPs make diagnoses and suggest drug therapies that could be vetted by pharmacists with a more detailed knowledge of drug efficacy and effects.
4. Re:It's expected by sjames · 2015-07-08 00:28 · Score: 1
  
  It goes even further. Half the crap people see doctors for is stuff they could take care of at home. Sometimes enforced by silly managers that demand a doctor's note if you're out with the flu for a couple days.
Modt healthcare workers work while sick by rossdee · 2015-07-07 15:03 · Score: 2

Since there isn't enough staff to cover your absence.
I'm not feeling the best tonight myself
But there are only 4 aides and 2 nurses listed on the online schedule and another one of the PM crew working half the NOC shift
full staff for nights is 1 nurses and 7 aides or 1 nurse and 8 aides
Watson, please hurry up! by Anonymous Coward · 2015-07-07 15:19 · Score: 0

The sooner human dr's are marginalized the better. No matter how many hours they work, no way to keep up with the speed of medical change.
I appreciate the job they all do, but cant wait for the improved versions.
It starts in med school. by mark_reh · 2015-07-07 15:23 · Score: 4, Insightful

They study for long hours without adequate sleep so they can learn to teach their patients how to live healthy lives. Then they get abused in the residency programs and work for less than minimum wage for 80 -100 hours per week. Then they finally finish and start to practice and have to work long hours without bathroom breaks, food breaks, or just letting off steam. They're getting screwed by insurance companies and hospital administrators at every turn. I'm amazed anyone still wants to go to med school in this country.
1. Re:It starts in med school. by known_coward_69 · 2015-07-07 16:06 · Score: 0
  
  i don't know. every time my kid gets sick with something simple it's like $400 - $500 the insurance company pays for two visits. and most doctors i see drive nice cars and live in nice and expensive homes. I know there are expenses but the kid is gets around 15-30 minutes of office time for both visits and it's like $400. and the doctor is usually pretty busy the whole day.
2. Re:It starts in med school. by Anonymous Coward · 2015-07-07 22:00 · Score: 0
  
  Not only that. Take an anatomy class sometime. In any other circumstance formaldehyde is treated as a toxic substance, in med school you huff huge amounts of it for 6 hours a day 5 days a week for a semester. You breath so much in that by the end of the class everyone is practically drooling.
3. Re:It starts in med school. by 140Mandak262Jamuna · 2015-07-08 00:54 · Score: 1
  
  I'm amazed anyone still wants to go to med school in this country.
  Don't worry on that count, right now the children of Indian-American immigrants are filling up the vacuum. When they realize the con job they got suckered into we will find another demographic.
  
  --
  sed -e 's/Chuck Norris/Rajnikant/g' joke > fact
4. Re:It starts in med school. by Anonymous Coward · 2015-07-08 00:54 · Score: 0
  
  That's because they want the walking-dead with healing skills.
5. Re:It starts in med school. by 140Mandak262Jamuna · 2015-07-08 00:59 · Score: 1
  
  i don't know. every time my kid gets sick with something simple it's like $400 - $500 the insurance company pays for two visits. and most doctors i see drive nice cars and live in nice and expensive homes. I know there are expenses but the kid is gets around 15-30 minutes of office time for both visits and it's like $400. and the doctor is usually pretty busy the whole day.
  Buddy, as an Indian-American I am drowning in a sea of doctors. Insurance companies have an invoice rate and they they actually pay something like 20cents on the dollar of the invoice amount. From that amount they pay the medical assistants, nurses, and database services to log into billing networks, liability insurance. I don't see doctors driving nicer cars than other people with Masters level education. (Not PhDs though. They end up in academics and drive Accords and Camrys. )
  
  --
  sed -e 's/Chuck Norris/Rajnikant/g' joke > fact
6. Re:It starts in med school. by mark_reh · 2015-07-08 01:32 · Score: 1
  
  Doctors/hospitals don't get the money that is billed. Insurance companies never pay the billed amount. Each transaction is negotiated between the medical office/hospital and the insurance company (think of the wasted time/ effort). Doctors in private practice still have to deal with insurance companies, unless they are doing cash only cosmetic work. Those guys deserve the money they get for putting up with the nutty patients they have to deal with.
  Doctors who work for hospitals are employees like everyone else. Yes, they generally get paid more than check-out clerks at the grocery store, plumbers, etc., but they spend many years and a LOT of money getting trained (and abused) to do their work, and must continue training at relatively high expense throughout their careers just to maintain their licenses. They typically work long hours under stressful conditions. If that doesn't deserve higher pay than most I don't know what sort of work does.
7. Re:It starts in med school. by Anonymous Coward · 2015-07-08 02:32 · Score: 0
  
  i don't know. every time my kid gets sick with something simple it's like $400 - $500 the insurance company pays for two visits. and most doctors i see drive nice cars and live in nice and expensive homes. I know there are expenses but the kid is gets around 15-30 minutes of office time for both visits and it's like $400. and the doctor is usually pretty busy the whole day.
  WTF are you bringing your kids in for routine viral infections ("something simple")? There is a reason you have copays and deductibles. To keep you from clogging the system unnecessarily. Get a good book on childhood illnesses. Keep your finger off the phone . Slow down, your kid will be fine.
universal precautions by markdavis · 2015-07-07 15:33 · Score: 2

>"95% of doctors believe patients are put at risk when doctors work while sick. Despite that, 83% of respondents said they had "come to work with symptoms"
If they are following universal precautions, it won't matter if they are sick or not... (yes, I work in healthcare). If they don't know this, they are not doing the right things.
1. Re:universal precautions by Firethorn · 2015-07-07 17:53 · Score: 1
  
  If they are following universal precautions, it won't matter if they are sick or not... (yes, I work in healthcare). If they don't know this, they are not doing the right things.
  The 'universal precautions' would include not coming into work when ill, wouldn't it? I mean, as far as preventing disease transmission goes, just look at how many hospital workers end up catching ebola, despite far more serious efforts to prevent it.
  As a doctor, you come in with the flu or something, just like anybody else you're likely giving it to your fellow employees and customers.
  
  --
  I don't read AC A human right
2. Re:universal precautions by Anonymous Coward · 2015-07-08 02:00 · Score: 0
  
  Except the customers are a lot more likely to be immunodefficient and the diseases are a lot more likely to be drug resistant.
Just trying to increase business.. by joe_frisch · 2015-07-07 15:33 · Score: 1

In today's competitive marketplace you need to do everything you can to generate more business.
Professional culture problem by Anonymous Coward · 2015-07-07 15:53 · Score: 0

This is just the latest in a line of problems with Doctor's making their patients sick, despite knowing better.
The more commonly known issue is the aversion or outright refusal to practice good hygiene (hand washing) between patients. There were multiple studies showing that the majority of hospital infections could be prevented by better hygiene standards, but doctors put up the most resistance.
There appears to be an ingrained cultural problem within the profession.
Often there's excuses like: "too busy", "not enough time", "they don't catch it from me", "I'll let co-workers down", "I won't get paid" and that's not good enough.
What happened to "do no harm"? Your responsibility is supposed to be foremost for your patients.
I've never seen a good reason why residents, or any other medical professional, are expected to do 16-20 hour shifts. Do you think _any_ patients want a sleep deprived person making life and death decisions? Yet it seems to be expected and a right of practice. Smells like initiation and bravado to me. As professionals, the public expects better from you.
Sometimes doctors should work when sick by davidwr · 2015-07-07 16:26 · Score: 3, Insightful

From a pure, selfless ethics point of view, the question is: Will humanity be better off if I go into work today or not?
Some things that may be going through doctors' heads when they decide whether to call in sick or not:
If I am sick and go in, then there's an increased chance of:
* me infecting others, and all that that implies
* me making a mistake that is worse than not being there at all
* Others perceiving me as not knowing/not following "the rules," which may impact my future career, which may negatively impact the future of the patients you would have had but won't have.
If I am sick and stay home, there's an increased chance of:
* A patient of a co-worker getting inferior care because my co-worker was covering for you
* A patient of a co-worker getting inferior care because my co-worker was tired because he covered for me in an earlier shift
* Others perceiving me as "not pulling my weight" and "wimping out," which may impact my future career, which may negatively impact the future of the patients I would have had but won't have
Similar thought patterns probably apply to most people in most careers.

--
Knowledge is how to play a game, intelligence is how to win, wisdom is knowing what game to play.
1. Re:Sometimes doctors should work when sick by drinkypoo · 2015-07-07 17:56 · Score: 1
  
  If I am sick and stay home, there's an increased chance of:
  * A patient of a co-worker getting inferior care because my co-worker was covering for you
  Conflict detected. They'd get superior care if you're the kind of person who would go give patients your illness.
  
  --
  "You're right," Fisheye says. "I should have set it on 'whip' or 'chop.'"
2. Re:Sometimes doctors should work when sick by AthanasiusKircher · 2015-07-07 21:03 · Score: 1
  
  From a pure, selfless ethics point of view, the question is: Will humanity be better off if I go into work today or not?
  Except your "pure, selfless ethics" sounds a bit too much like egotistical BS in places.
  
  If I am sick and stay home, there's an increased chance of:
  * A patient of a co-worker getting inferior care because my co-worker was covering for you
  Every doctor is not "God's gift to humanity." Unless you are in the top 5% or whatever of physicians -- and most doctors obviously aren't -- this is egotistical nonsense. If you're really worried that your colleagues do crappy work, get a better job.
  
  * A patient of a co-worker getting inferior care because my co-worker was tired because he covered for me in an earlier shift
  This is a pervasive staffing issue in medicine. Except in times of war or unexpected epidemics (or if you're a true specialist with an emergency situation), there is no reason this crap should be a concern. If it is, it points to how broken the medical system is... train more doctors. Hire more doctors. Given how people's lives depend on medical care, doctors and hospitals that are understaffed are the ones who are operating under pervasively "unethical" conditions... there's nothing "selfless" about this.
  
  * Others perceiving me as "not pulling my weight" and "wimping out," which may impact my future career, which may negatively impact the future of the patients I would have had but won't have.
  Oh, good lord. Yes, those poor future patients who will never have the good fortune to experience the great glory of your magnificence. Again, unless you truly are one of the best doctors in your generation (and changes are that you AREN'T) this is a preposterous argument.
  If this is the kind of egomaniacal insanity that passes for "selfless ethics" in medicine, doctors really need to get a clue about their own limitations and abilities. I know quite a few doctors, and I've rarely met one who would be justified in this sort of thinking.
3. Re:Sometimes doctors should work when sick by Anonymous Coward · 2015-07-07 22:14 · Score: 0
  
  And here is what should be going through their head: why are we staffed so poorly that it puts patients at risk.
  I work in the medicine and I use to have these moral dilemmas until I started to notice how the budget is spent (we've been asking for needed equipment for YEARS, and somehow there is never enough money for that, but always enough money for some poorly implemented initiative that will accomplish fuckall) the staff to administration ratios, and, oddly enough, that we've never had more staff, and yet are more overworked than ever (overstaffed when the bigwigs are present, skeleton crews every other time).
  And I realized coming in sick ultimately is just covering for incompetent management, and nothing will ever change by putting the onus on me. I shouldn't have life or death matters placed in my lap for simply being ill. That is a sign of a poorly designed system.
4. Re:Sometimes doctors should work when sick by Anonymous Coward · 2015-07-08 07:57 · Score: 0
  
  Even a worse doctor can be expected to give better care to their own long-term patient than to the one they just met.
Restaurant waitress/cashier by davidwr · 2015-07-07 16:29 · Score: 1

Name one job which doesn't encourage you to go in to work even when you are sick.
Some (but sadly not all) fast-food and restaurant chains know the PR damage that will happen if a customer tells their friends "I went to $RESTAURANT but my waitress had a runny nose, ewww".
For their own selfish reasons, these businesses insist that customer-facing employees not show visible signs of being contagious. Oh, they don't come out and say it like that - their written policy probably says "don't come in if you are sick" - but what they really want you to do is not come in if you are going to scare away customers.

--
Knowledge is how to play a game, intelligence is how to win, wisdom is knowing what game to play.
1. Re:Restaurant waitress/cashier by Anonymous Coward · 2015-07-08 00:17 · Score: 0
  
  And they come in anyway because those types of employers usually don't offer paid sick leave and the type of people that work there can't afford to miss a day's pay.
Not just Doctors by EzInKy · 2015-07-07 16:29 · Score: 2

It seems unfair to me to pick on them. All allied health professionals are expected to work whether they are sick or not. It is just the result of the prevailing Judeo/Christian work ethic. Catholics seem to be the worst as personal sacrifice is expected by their beliefs, science be damned.
For example, one of the first things that got discarded was our previously secular hospital's very sane policy of forgiving a sick call by working an extra shift after being placed under the management of a Catholic institution. Apparently to their mind, if you can walk you can work.
In the meantime hospital acquired infections continue to be on the rise, and in many cases more deadly.

--
Time is what keeps everything from happening all at once.
95% of people know speeding is bad. by Anonymous Coward · 2015-07-07 16:50 · Score: 0

95% of people know speeding is bad. Despite that 83% said they "were speeding at some point" in the last year.
1. Re:95% of people know speeding is bad. by david_thornley · 2015-07-08 09:11 · Score: 1
  
  Speeding is not necessarily bad. Going significantly slower than traffic will probably cause more accidents.
  
  --
  "When you have eliminated the unacceptable, whatever is left, however improbable, must be the truthiness" - Holmes
Doctors patient by Anonymous Coward · 2015-07-07 19:19 · Score: 0

As a doctor I can only say: from the very start of medical school it is instilled in aspiring doctors that someone who is sick, is a patient. And a patient, that is someone who is on the opposite side of your desk / on your examination bench / in your waiting room / etc., in short, is anyone BUT you. Therefore doctors will rarely admit they are sick as that would be akin to de-identifying from your professional (and, after a while also personal) identity.
Drs... by Anonymous Coward · 2015-07-07 22:07 · Score: 0

As far as a dr is concerned, getting patients ill could be seen as an advantage for them, so they can be seen more and stay in longer.
Patient dies? Fine, theres always another one and theres a shortage of beds anyway.
all the pressures of ticking boxes and meeting targets does not fit with taking time off. And the mortgage on the mansion and cars needs paying. Besides, many drs think they are irreplaceable gods who know best about everything and if you disagree youre wrong by default.
Nurse Practitioners by Anonymous Coward · 2015-07-07 23:05 · Score: 0

I haven't had much experience with Doctors fortunately, but the last few visits made me feel like they were the equivalent of 1st level helpdesk.

This is why so many, in the US, are pushing to replace most GP visits with visits to a Nurse Practitioner. NPs can be quite effective in their role (sometimes more effective than a GP since they suffer less of a deity complex) so I'd call them 2nd level support.
It's all about the Insurance Profits by ka9dgx · 2015-07-07 23:26 · Score: 1

When you have middlemen (Insurance Companies) and administrations working to maximize profit, all being paid by the procedure... the quality of each procedure is far less important that the quantity. We need to put health back in the drivers seat as the #1 priority... which isn't going to happen until we Nationalize health care... even then it's not guaranteed to happen.
It's not a simple equation by sjbe · 2015-07-07 23:30 · Score: 1

Does the inconvenience of one doctor outweigh the inconvenience of 5 patients catching what he's got?
Sometimes yes. Sometimes no. And the answer depends on what he's got and what the consequences of him not showing up for work are. There are places where the doctor is the only qualified medical professional around. Should the gunshot victim have to wait a few days for the doctor to get over his bout of the sniffles before he gets help? Should patients in urgent need of care in a rural area have to wait for a week for a doctor to stop coughing when he's the only medical help within reasonable distance? It's not always a simple equation. Sometimes the answer is obvious. Other times not so much.
Bear in mind too that many small practices shut down if the doctor cannot come to work regardless of reason. My wife works in a practice this size. There are about 10 hourly employees that don't get paid if the office cannot open. Fortunately the type of practice they have doesn't deal in emergencies but there are significant economic consequences to more than just the doctor. That means that the illness needs to be of a significant severity before it's reasonable to shut everything down. Doctors work around sick people so unsurprisingly they tend to catch what patients have more often than a typical office worker. Sometimes they have backup (like in a big hospital) and can stay home for a little while to recover. Other times the harm of staying home is greater than the risk of transmitting a minor illness. It's unfortunate but that's the reality of it.
1. Re:It's not a simple equation by AK+Marc · 2015-07-08 08:33 · Score: 1
  
  Bear in mind too that many small practices shut down if the doctor cannot come to work regardless of reason.
  That's why PAs exist. They are the doctor, for most purposes, and the doctor doesn't need to be there. They must be "supervised" by a doctor, but I've been told that supervision doesn't require an on-site presence.
  
  The small practices near me stay open, with the PA running it, if the doctor isn't around.
  
  --
  Learn to love Alaska
Close, but not quite by ThatsNotPudding · 2015-07-07 23:39 · Score: 1

I think this is one aspect of poor management., Management sets the tone - do they complain etc. when you call in sick? If they don't, then people take off when they are sick.

Not exactly. The 'miracle' of American worker productivity is that most of us are now doing our work and the work of the poor sap that got laid-off during the Sub-Prime Pyramid Recession. Now, we're all too terrified to call in sick lest we be tagged as lazy or disposable. So we all work sick, because we need the health insurance (hashtag: irony).
Re:Doctors patient by adhdengineer · 2015-07-07 23:39 · Score: 2

holy christ this. IANADBIAMTO (I am not a doctor, but I am married to one). She is the worst patient in the world. The absolute worst.
Reforming medicine by sjbe · 2015-07-08 00:38 · Score: 2

That just seems to imply that doctors shouldn't be trained to work stupid-long immune system destroying hours, should be overstaffed (not understaffed) to allow for frequent sick days, etc.
That would be nice but it cannot realistically happen without a single payer government run health care system. Since that is a political impossibility it seems unlikely to happen. Furthermore, low staffing levels are sometimes an economic or functional reality. If you work in a rural area, odds are good there is no backup. Long hours? That's not unusual in a lot of professions including programming. Given the almost limitless need for medical care I don't really see doctors ever working short hours. It's just not a 9-5 sort of profession. Overstaffing will not lower medical costs - quite the opposite. So how do you propose to overstaff AND reduce the already outrageous cost of medical care in the US without going to a government run medical system? That's just not economically realistic.

In other words, double the number of medical schools, reduce the on-call stress that hurts the immune system and reform the residency system.
Doubling the number of medical schools will not necessarily have your desired effect and cannot be done overnight. For one, who is going to teach in them? Basically the only people qualified to teach doctors are other doctors. It would take a generation or two at minimum to double the number of med schools. And how do you do it without lowering standards? I can assure you that the lawyers would LOVE it if standards for doctors were lowered.
As for reforming the residency system, I agree completely there. My wife is a MD and the residency system is a soul crushing hazing ritual from a bygone era that needs reform drastically. The biggest problem with it is that the residents are funded primarily by the government so they are essentially free labor to the hospitals they work in. So the hospitals use them as hard as possible to save money on their own bottom lines. It's a huge profit center which makes it very hard to reform.

Maybe also get rid of the concept that doctors are so much smarter/more honorable than the poluace instead of just having a different skillset.
Just as soon as ambulance chasing lawyers cease to be a thing. Doctors ARE quite frankly held to a standard that you probably are not in your job and I certainly am not in mine. They have to constantly be considering whether they will be sued because most are at some point. My wife has to write all her reports bearing in mind the non-trivial possibility that she may have to defend it in a courtroom. She can even do everything properly with the best standard of care and she still is likely to get sued at some point. Her. Personally. Do you have to worry about that constantly in your job? I'm guessing probably not. Do you have to buy expensive liability coverage? I'm guessing probably not. Doctors ARE held to a higher standard than most other professions. People are extremely unforgiving of mistakes in medicine despite the fact that such mistakes are 100% inevitable because the human body is incredibly complex and we don't understand a lot about it.
1. Re:Reforming medicine by Anonymous Coward · 2015-07-08 04:36 · Score: 1
  
  That would be nice but it cannot realistically happen without a single payer government run health care system.
  There is a shortage of doctors because the supply is controlled by the doctor's guild, who have an incentive to maximize their own utility. Legalize all drugs, end prescription requirements, and deregulate the medical industry. Let the consumer decide who to trust. Let the consumer kill himself by listening to homeopathic doctors and witch doctors instead of letting the doctor's guild kill the rest of us with overpriced health care.
  If you think we're entitled to health care as a human right that's a good argument for a basic income which can afford it, but forcing us to buy a product from a specific group of people, or forcing us to prioritize health care over other needs, will only lead to exploitation.
2. Re:Reforming medicine by Anonymous Coward · 2015-07-08 12:32 · Score: 0
  
  A bit off topic from the OP.
  I've been told the average doctor spends more time in court in America than the average criminal. If you create a risk, don't complain if people act in a risk-averse manner. In the case of medicine, for US docs that's a 6 figure insurance bill. And the best part of that: I believe in any payout the lawyers get about 1/3.
  As "every system is perfectly designed to produce the results that it does" , the American people need to decide if they're happy with their system. If they're not, there are options. Most countries recognise that lawyers and healthcare are a poor mix- Life continues to have a 100% mortality rate, despite many lawyers thinking they can alter that by suing. Despite the lawyers being caged in other countries, outcomes are comparable to the US (and at about half the GDP). If it was a business, you'd need to be mad to buy shares in it.
  Many countries have hours restrictions - the EU and Australia aim for about 50h/week max for trainees. The US brought in a rule a few years back that restricted them to no more than 80 h/week, and they were convinced it was going to wreck standards- go figure.
  Doubling the number of med schools has been done. Australia increased med school intakes by between 50 and 100% in all states between 2005-12. The outcomes are still boiling through the system, but at this point there isn't a deterioration in care.
Economic value is more robust than that by sjbe · 2015-07-08 00:47 · Score: 1

If a doctor contaminates patients, then the economic value of his work day is probably negative.
Unless he has a case of ebola that is unlikely to be true. Doctors and medical staff work around sick people all day. It is a virtual certainty that they will regularly transmit pathogens no matter how careful they are. Fortunately most people have robust immune systems so the system still works. Or would you rather that entire medical offices close every time someone gets a case of the sniffles?

I noted the point of high workloads, but it just suggests that we need more doctors, and that subsiding would make sense.
Training of doctors is already subsidized. It's primarily paid for through Medicare and the Department of Health and Human Services. This is actually a problem because since the hospitals are not paying for their residents they are effectively free labor. This creates a strong incentive for hospitals to wring every possible ounce of work out of these "unpaid" but talented workers.
1. Re:Economic value is more robust than that by manu0601 · 2015-07-08 05:25 · Score: 1
  
  Fortunately most people have robust immune systems so the system still works
  We are talking about sick people, right? Or perhaps you believe people waste their time waiting to see the doctor just for the fun?
Triage by sjbe · 2015-07-08 00:49 · Score: 1

Prioritize the patient queue based on similar symptoms.
It's called triage and I assure you that medical people are well aware of it. Particularly in ERs.
Lowering standards is a dumb idea by sjbe · 2015-07-08 01:00 · Score: 1

If you drastically reduce the requirements for becoming a doctor, then you'll get prompt treatment from a well-rested doctor who can afford to spend a good long while with you and still charge you less. Sure, they'll make some mistakes... but so do current doctors.
And you'll get a lot of shitty doctors, drive up medical costs, drive up liability costs and hurt a lot of people in the process. Increasing the number of doctors is fine but lowering standards to do it is a DUMB idea. A better idea is to make working as a doctor more appealing so that you attract more good people to the profession. There are plenty of people who are smart enough to be doctors but who simply don't want the (often) horrid lifestyle that comes with it. This can be done without admitting a bunch of second rate applicants to medical school.

Requiring less training might actually reduce the number of mistakes.
Let me let you in on a little secret. EVERY doctor has killed someone. Not intentionally of course but because of a mistake they have made. Statistically the worst time to go into a hospital in the US is in late summer because that is when all the new interns start. They learn by working on you and there is no other way to do it. You can improve training without requiring less of it. Do you really want a minimally trained surgeon with no oversight working on you?
Osteopathic Physicians by Guppy · 2015-07-08 06:56 · Score: 2

FYI, but you may be interested to know that the AMA does not have quite the monopoly on producing new physicians that you think.
There is actually a second source of physicians in the U.S., the American Osteopathic Association. Just after the civil war, Osteopathic Physicians (who carry the D.O. degree instead of M.D.) split off from mainstream medicine. While initially a fringe movement focused on Osteopathic Manipulation practices, over time it eventually evolved into a full-fledged "second track" for producing physicians of pretty much all different types. Since then, D.O.s have been growing in number, and unlike M.D.s the majority enter the primary care fields (Family Medicine, General Internal Medicine).
Note that this is a distinct USA phenomenon, as Osteopaths in other countries are not licensed physicians and are more like chiropractors.
The graveyards are full ... by Anonymous Coward · 2015-07-09 09:58 · Score: 0

... of indispensable men.
The graveyards are full of indispensable men.
Nobody pointing out this study is about USA by ToddInSF · 2015-07-09 14:43 · Score: 1

doctors.

And likewise, no mention of the crappy USA culture of greed, exploitation of labor, and money-grubbing being responsible ?