When I started medicine, It wasn't at all unusual to do 120+ hours per week, for about £23000 (about $37000); on average, I probably worked around 70 hpw. The hospital also refused to audit our hours. However, things have improved in the last few years; I now get about £46000 (?$65000) for an average week of about 60 hours; maximum shift length I have done in the last 4 months has been 81 hours straight, but not usually more than 56. As of very recently, max is usually 14 hours in one go.
Some of this pay rise is due to me becoming more senior - about £10000, the rest from re-working of the hours systems.
The only problem is, same number of hours to cover, same number of docs - now we just work shorter shifts, more often, much more anti-social, and reduce the number of pepole on at times. I much preferred the old system.
PS I can expect about £55-70000 when I am a consultant, which will be my final salary, after about 8-15 years post-grad. Oddly, just before you become a consultant, you'll make £50-90000 because you do so much more overtime...
Interestingly, I had an idea for a piece of software which is pretty simple in theory; I approached a software developer with it, and it's now being developed (hopefully it will make me rich, but you never know...). The beauty is that they are specialists in interface - what they usually do is work for companies with an in-house solution which does the job, but is hard to use, and simply put a new shiny usable front end onto it.
So if my software is ever put into production, it will be entirely developed for usability, which is most of its point - I'm just surprised more companies haven't thought of this.
PS the company I am involved with are making a fortune with what they offer - you would think other people would notice and take the hint...
BSA recognizes that, for whatever reason, your company may not have managed its software assets properly.
So they're admitting that keeping all these bits of paper, discs and whatever else for different places at different times, coupled with human error, misplacement, damage and incompetence, could be less than possible 100% of the time?
No shit, Sherlock. But the bastards are prepared to charge you for something you might have already paid for? This is utter nonsense. They have to prove it's pirated. What about records, e.g. receipts, or bank records with the value of 50 licences, or store records with the sale if it was cash, or any of a thousand other possiblilties?
I know it's obvious that this is flagrantly illegal, but at least you would think they could disguise it, and not admit on their letter that they are being unreasonable.
That'd be pretty hard to prove - who's to say you didn't replace 23 valid licences of Windows 3.1 with 23 new ones for XP because you were uprgading? They don't know what was on the machines before. They certainly don't have the authority to check anything other than what software is on what machine, and does it have a licence. Come to think of it, they odn't have that right either...
The bends are the result of pressurised gas in the bloodstream at depth becoming de-pressurised when sufacing and hence less soluble - gas bubbles then form in the blood vessels and occlude blood flow, leading to the clinical manifstations.
This is more a problem with diving as the body is directly pressurised by the surrounding water. In a submersible, the pressure does not necessarily need to increase - the hull takes the pressure. So the bends don't need to occur as you can maintain atmospheric pressure in the actual internal environment of the sub.
Hang on, you mean Koko the gorilla could be sued for any noises he makes because he has no right to free speech? In the US, tht wouldn't surprise me one bit...
The drugs which are on the market make a big difference to a lot of people with mental illness; the problem is that not all the people who take them have mental illness. There is a big difference between someone with a good-going clinical depression (which I presume you had from what you said) and someone who is unhappy. Everyone is unhappy at some point; if it is a reasonable response to circumstances (e.g. bereavement, unemployment, whatever) then that is normal; if it is a prolonged or abnormal response (depressed without any particular reason, unable to get out of it) then this may be abnormal.
The problem in recent years has been their abuse - a third (or more) US citizens take them. A third are not clinically justified. There are many reasons for this, among them private medicine (financial gain for the MD who prescribes them, lost business if he doesn't as the 'patient' simply goes to someone else and gets them there), litigation (MD is sued if he makes a wrong diagnosis and the patient tried to commit suicide or whatever - it is very easy to justify a prescription if you need to, so it's much harder to sue if you've been overtreated), and the convenience lifestyle of the US - fast food; 24h access to anything you want; kids being normal, boisterous kids but you are too tired to deal with them? Ritalin should sort that out; bad day at work? Have a valium.
There are legitimate uses for these drugs, but they have become abused. Which is what makes them not very different from street drugs.
I am not saying that they should not have this facility - what I am saying is that the priorities are wrong. A similar investment could sort out a lot of humanitarian problems. The bottom line is that a lot of these people you speak of who live in villages with no phones around don't know anyone outside the villages, so they don't need phones, and would much rather have a safe water supply.
The fact that this is being offered by a private company does not make it any different. It just means that they are after a profit. The same money that would have otherwise been used for essentials is now used for a luxury.
I'm not saying this won't benefit anyone - to the relatively affluent, this will be great. But the problem is, the vast majority are not affluent, and this may just make the rich-poor divinde even wider.
I assume you are from India. You have internet access, so you are one of these relatively affluent people I am speaking about. Of course you will be glad to be able to get cheap phone calls. The point is that most people in your country don't care if they are cheap or expensive, they don't use them.
I think this is an excellent idea. Who cares about TB, poverty, high infant mortality, and potential nuclear war with your neighbours if you can play cheap networked Quake on your phone?
It is all very well to say that there is such a large population that a tariff like this might be feasible. But outside the major cities, would they want it, or even care about it?
Or even better, the US "government" will use their new presidentially approved authority to allow the military to assassinate you (I shit you not!) by claiming you are a terrorist. Without trial.
Worryingly enough, they do now have that authority - it was in the news a few weeks ago that there are about 20 Al-Q suspects (note - suspects, not ever been subject to trial) who the military have been authorised to kill if it would be too difficult/dangerous to capture. And more can be added to this list without presidential say-so. It truly is the beginning of the police state, and the end of civilisation if this is allowed to happen.
I agree with your comments - but there is a lot more to it than simply pointing out how things could be done better, just as you could look at a variety of political decisions and say "What the fuck?" as they are often inherently stupid. The thing is these things evolve over time, and it only takes one idiot in the chain...
Doctors would do well to use computer aided diagnosis - if they prove their potential. A few things stop that - lack of suitable computer facilities ( you wouldn't believe some of the machines running in some hospitals, in major cities - for instance windows 3.1 and sub 60MHz processors(!)), a certain level of distrust (remember a lot of the previous generation of doctors never used, and still can't use, computers), lack of evidence (all the evidence is pretty anecdotal - no double blind randomised controlled trials, which is really what has to happen). Until one has shown these to be statistically significantly better than humans, using one only opens yourself up to litigation. What if it's wrong? If it isn't standard practice, you are up shit creek. It will come eventually, but these are recent databases (at least with any real usability - the shit ones have been around a while) and have to prove themselves. It will take off when the recent crop of computer-literate docs progress through the system, probably as an adjunct to traditional diagnosis, at least in the early stages.
As for the rate of success / complication... the problem with this is that even if you have good success rates, any individual you operate on has either a 0% or a 100% chance of (significant) complication. As I said about the good doc / bad doc scenario, having the best success rate in the world may not necessarily mean that failures are simply accidents. Equally being crap doesn't mean that patients suffer complications.
The current system - audit, whistle-blowing and peer review, is probably the best system given the circumstances. However, for several reasons (grudge, patient's unhappiness with treatment regardless of result or possibility of error) this system is bogged down with doctors, suspended on full pay, often for months without appeal, for whom the allegations are eventually shown to be false. Certainly the system has to be in place to allow this review, but the vast majority of accusations are found to be baseless.
Essentially, the current system is by no means perfect. Shit docs get away with ineptitude, and good docs suffer vendettas. But it's still the best system available, allowing anonymous accusations from worried colleagues as well as review of success rates.
A last problem is the perception of blame. A surgeon can perform a faultless operation, care can be perfect, but the patient can still suffer problems. In a climate of litigation, this can still result in a successful claim - certainly in Britain where I practice, the NHS provides some liability cover. However everyone takes out their own insurance as the hospital risk managers will rarely opt to defend a case - even when it is patently defendable, to avoid legal bills which are often in excess of the offer.
The review board is usually separate from the institution (e.g GMC here) and is generally acknowledged to be fair. It also has non-medics on it.
Essentially, there is no right or wrong answer currently - but until someone proposes a better system, we are stuck with this one. Incompetent docs have to be accountable, but the problem is that these are the minority, and (very) often good doctors make mistakes too.
When I say degraded, I don't mean technically processed somehow. I mean shit.
If this is the biggest growth area in the music industry, then I am sure that the record companies are wanting a slice of that action. Hence, they will license these tracks. So whether you got you song on DVD, CD, MP3 or ring-tone, it's all licensed by the same company.
My point is that you have bought the licence from the company, you should be able to listen to the music any way you want.
Re:Deserved
on
Complications
·
· Score: 3, Interesting
There used to be money, prestige and all the rest. That's not really there any more. To some extent it still exists in the US, but certainly in the UK doctors are increasingly treated like shit.
The book itself I have read some of - it makes a series of excellent points; one of which in the tagline - "notes on an imperfect science". We don't know very much about the human body compared to how much there is. All a doctor has to go on is a series of symptoms and an examination, followed by some lab tests. Most illnesses are diagnosed from the symptoms. Surprisingly few from the examination. Lab tests are mostly non-specific - they can confirm or refute your diagnosis, but a minority will actually make a diagnosis on their own.
The problem is that symptoms are very non-specific. Only a tiny minority of people with chest pain have a cardiac (or other "serious")cause for it. At the same time, a few people will have a serious disease but the symptoms are not typical of it. Do you investigate everyone for every disease? No, takes far too much resources with only a tiny return. What is done instead is the doctor listens to the story, examines the patient, and tests for the likely (in view of his findings) causative process, and also any serious (i.e. missing these would be bad shit) things which might give similar symptoms.
Everyone has an area of expertise - and also a finite amount of knowledge. Doctors cannot know everything, but will, if indicated, refer to another specialist with an appropriate area of interest, which will increase the chances of a diagnosis.
Bear in mind another few things - half of all people are below average intelligence; i.e. half of physicians are of below average ability; symptoms are often misleading, and tests and investigative surgery can cause their own problems, and you see my point - any area of medicine is a risk/benefit analysis. At the end of the day it's all probability - gambling with your life, in essence.
Doctors, usually, do try and make the best decision. It can't always be right. Incompetent and dangerous docs are one thing - they should be re-trained if possible, and struck off if not. The point made by the book is that all good doctors make mistakes as well. This is part of human nature, the problem is that the consequences can be grave.
The thing is, is it any different to be treated by the best surgeon in the world, with the lowest complication rate (there is no such thing as no complications), or the worst in the world, with the highest? If you get complications, you are still in the same boat. But what if you get no complications from the shit guy? What if he's competent, but that the unit he works in isn't, because it has less support staff than another unit?
One or both of them might be competent or not. But the fact that someone suffers a complication is a far more difficult question to deal with - it may be that no one is at fault. Some of these things simply just happen.
What? If you agree to a contract, and the rates are too high, it's no-one else's problem but your own.
Until loan-sharking is made illegal.
The difference is in scale only. They do exactly the same thing that banks do (save for the heavies that come round when you don't pay up...).
The earlier poster's entire point was the arbitrary definition of "illegally exorbitant". This is an imposed definition. That was his point. You have missed it entirely.
What if you own the CD - should you pay again to listen to a degraded version? Bugger that, once I've paid royalties I think I have a permanent licence to listen to that particular track. It's the whole time-shift / space-shift thing from another angle. If you own the VHS, is it piracy to download the DivX?
I would be interested to know: if these mice have been produced, then the likelihood is that they have either been genetically modified, or more likely (and arguablly, also geneticaly modified) selectively bred to produce a sort of "anti-Darwin" mouse. The gene sequence, whether it is a cancer-causing DNA sequence or a lack of cancer-protecting DNA, has been patented.
If someone in the US breeds mice, and by accident a strain happens to have similar or identical DNA sequences which give it the big C then is this a violation of patent? And what if the genes have never been sequenced, it's just known that they get cancer and are sold for research? If retrospectively we find out that they violate patents, it would see a bit stupid that the mice breeding (under only some human control and with the inbuilt unpredictability of fertilisation and DNA replication) could be illegal.
Patenting nature just seems very wrong to me. Just because I decode some of nature's best work shouldn't mean that I own it.
I agree. I'm still laughing. If only I had mod points, but despite my excellent karma (how, I don't know) and membership for about a year, still none. Have I offended someone?
Although I'm currently typing this from my Mandrake 9.0 box, with an Alcatel speedtouch USB modem. Up and running no probs, detected on installation.
On the other hand (as always) while I've got it up and running no probs (other than DL'ing one file) on every MDK distro since 8.0 (didn't try any previous), Red Hat, SuSE and Slackware weren't interested. I know you're meant to be able to, but when I have a distro that gets it going easily, why bother? Life's too short. It was, incidentally, easier than doing it on windows as well. (XP and 98)
While this by no means disproves the common "USB won't work in Linux" problems, it does show things are happening. It would be a shame though if all the other distros lost out because they didn't provide functionality that's been present for years in MDK's line-up.
Oddly enough, after the installation, I have trouble with the OS believing there is a network connection, but that doesn't stop it accessing the internet.. just denies ther's a connection present.
(Currently training to be a surgeon, present job in orthopaedics, FWIW)
Most of the surgeons I have come across have been remarkably concerned about their patients - far more so than you would imagine. As I already said, it is quite possible that hips could be better, the problem is that developing them, for the tiny minority that need 'changeable' hips, would be prohibitively expensive. But add up coming up with an idea, and implementing it in enough people to give evidence that it's better (as you can see from the comment above, this might take 8-20+ years to prove), it is something most profit-oriented companies would rather not think about. The current lot do their job admirably, and beating them would be expensive, if not unfeasible. The 8-20 years R&D, and several, possibly litiginous, human subjects, are the problem. If they make a mistake with a prototype, the 50 or so people that they need (they might get away with 10-20) to prove their implant is better will have to be compensated if it is significantly worse. If it is no better, it's all wasted time and money. Animal studies would take just as long and are not directly comparible, the main problem is that human studies = liability.
Having some experience in the field, I would far rather be an engineer than a surgeon. These days, eveyone hates doctors.
I don't know how things compare in France - I imagine that they end up quite similar. The surgeons do a combination of what is best for the patient and what is practical (theatre time, available beds etc.). The companies that make the hips are marketing a product - maximise profit is their mantra. Neither are infallible, and while there are (more rarely than the media would like us think) unethical surgeons, big business and hospital management are far more likely to be the corner-cutting cost-cutters than the surgeon.
Slashdot Mirror
Some of this pay rise is due to me becoming more senior - about £10000, the rest from re-working of the hours systems.
The only problem is, same number of hours to cover, same number of docs - now we just work shorter shifts, more often, much more anti-social, and reduce the number of pepole on at times. I much preferred the old system.
PS I can expect about £55-70000 when I am a consultant, which will be my final salary, after about 8-15 years post-grad. Oddly, just before you become a consultant, you'll make £50-90000 because you do so much more overtime...
So if my software is ever put into production, it will be entirely developed for usability, which is most of its point - I'm just surprised more companies haven't thought of this.
PS the company I am involved with are making a fortune with what they offer - you would think other people would notice and take the hint...
So they're admitting that keeping all these bits of paper, discs and whatever else for different places at different times, coupled with human error, misplacement, damage and incompetence, could be less than possible 100% of the time?
No shit, Sherlock. But the bastards are prepared to charge you for something you might have already paid for? This is utter nonsense. They have to prove it's pirated. What about records, e.g. receipts, or bank records with the value of 50 licences, or store records with the sale if it was cash, or any of a thousand other possiblilties?
I know it's obvious that this is flagrantly illegal, but at least you would think they could disguise it, and not admit on their letter that they are being unreasonable.
This is more a problem with diving as the body is directly pressurised by the surrounding water. In a submersible, the pressure does not necessarily need to increase - the hull takes the pressure. So the bends don't need to occur as you can maintain atmospheric pressure in the actual internal environment of the sub.
The problem in recent years has been their abuse - a third (or more) US citizens take them. A third are not clinically justified. There are many reasons for this, among them private medicine (financial gain for the MD who prescribes them, lost business if he doesn't as the 'patient' simply goes to someone else and gets them there), litigation (MD is sued if he makes a wrong diagnosis and the patient tried to commit suicide or whatever - it is very easy to justify a prescription if you need to, so it's much harder to sue if you've been overtreated), and the convenience lifestyle of the US - fast food; 24h access to anything you want; kids being normal, boisterous kids but you are too tired to deal with them? Ritalin should sort that out; bad day at work? Have a valium.
There are legitimate uses for these drugs, but they have become abused. Which is what makes them not very different from street drugs.
The fact that this is being offered by a private company does not make it any different. It just means that they are after a profit. The same money that would have otherwise been used for essentials is now used for a luxury.
I'm not saying this won't benefit anyone - to the relatively affluent, this will be great. But the problem is, the vast majority are not affluent, and this may just make the rich-poor divinde even wider.
I assume you are from India. You have internet access, so you are one of these relatively affluent people I am speaking about. Of course you will be glad to be able to get cheap phone calls. The point is that most people in your country don't care if they are cheap or expensive, they don't use them.
It is all very well to say that there is such a large population that a tariff like this might be feasible. But outside the major cities, would they want it, or even care about it?
Priorities, people.
Worryingly enough, they do now have that authority - it was in the news a few weeks ago that there are about 20 Al-Q suspects (note - suspects, not ever been subject to trial) who the military have been authorised to kill if it would be too difficult/dangerous to capture. And more can be added to this list without presidential say-so. It truly is the beginning of the police state, and the end of civilisation if this is allowed to happen.
Doctors would do well to use computer aided diagnosis - if they prove their potential. A few things stop that - lack of suitable computer facilities ( you wouldn't believe some of the machines running in some hospitals, in major cities - for instance windows 3.1 and sub 60MHz processors(!)), a certain level of distrust (remember a lot of the previous generation of doctors never used, and still can't use, computers), lack of evidence (all the evidence is pretty anecdotal - no double blind randomised controlled trials, which is really what has to happen). Until one has shown these to be statistically significantly better than humans, using one only opens yourself up to litigation. What if it's wrong? If it isn't standard practice, you are up shit creek. It will come eventually, but these are recent databases (at least with any real usability - the shit ones have been around a while) and have to prove themselves. It will take off when the recent crop of computer-literate docs progress through the system, probably as an adjunct to traditional diagnosis, at least in the early stages.
As for the rate of success / complication... the problem with this is that even if you have good success rates, any individual you operate on has either a 0% or a 100% chance of (significant) complication. As I said about the good doc / bad doc scenario, having the best success rate in the world may not necessarily mean that failures are simply accidents. Equally being crap doesn't mean that patients suffer complications.
The current system - audit, whistle-blowing and peer review, is probably the best system given the circumstances. However, for several reasons (grudge, patient's unhappiness with treatment regardless of result or possibility of error) this system is bogged down with doctors, suspended on full pay, often for months without appeal, for whom the allegations are eventually shown to be false. Certainly the system has to be in place to allow this review, but the vast majority of accusations are found to be baseless.
Essentially, the current system is by no means perfect. Shit docs get away with ineptitude, and good docs suffer vendettas. But it's still the best system available, allowing anonymous accusations from worried colleagues as well as review of success rates.
A last problem is the perception of blame. A surgeon can perform a faultless operation, care can be perfect, but the patient can still suffer problems. In a climate of litigation, this can still result in a successful claim - certainly in Britain where I practice, the NHS provides some liability cover. However everyone takes out their own insurance as the hospital risk managers will rarely opt to defend a case - even when it is patently defendable, to avoid legal bills which are often in excess of the offer.
The review board is usually separate from the institution (e.g GMC here) and is generally acknowledged to be fair. It also has non-medics on it.
Essentially, there is no right or wrong answer currently - but until someone proposes a better system, we are stuck with this one. Incompetent docs have to be accountable, but the problem is that these are the minority, and (very) often good doctors make mistakes too.
If this is the biggest growth area in the music industry, then I am sure that the record companies are wanting a slice of that action. Hence, they will license these tracks. So whether you got you song on DVD, CD, MP3 or ring-tone, it's all licensed by the same company.
My point is that you have bought the licence from the company, you should be able to listen to the music any way you want.
The book itself I have read some of - it makes a series of excellent points; one of which in the tagline - "notes on an imperfect science". We don't know very much about the human body compared to how much there is. All a doctor has to go on is a series of symptoms and an examination, followed by some lab tests. Most illnesses are diagnosed from the symptoms. Surprisingly few from the examination. Lab tests are mostly non-specific - they can confirm or refute your diagnosis, but a minority will actually make a diagnosis on their own.
The problem is that symptoms are very non-specific. Only a tiny minority of people with chest pain have a cardiac (or other "serious")cause for it. At the same time, a few people will have a serious disease but the symptoms are not typical of it. Do you investigate everyone for every disease? No, takes far too much resources with only a tiny return. What is done instead is the doctor listens to the story, examines the patient, and tests for the likely (in view of his findings) causative process, and also any serious (i.e. missing these would be bad shit) things which might give similar symptoms.
Everyone has an area of expertise - and also a finite amount of knowledge. Doctors cannot know everything, but will, if indicated, refer to another specialist with an appropriate area of interest, which will increase the chances of a diagnosis.
Bear in mind another few things - half of all people are below average intelligence; i.e. half of physicians are of below average ability; symptoms are often misleading, and tests and investigative surgery can cause their own problems, and you see my point - any area of medicine is a risk/benefit analysis. At the end of the day it's all probability - gambling with your life, in essence.
Doctors, usually, do try and make the best decision. It can't always be right. Incompetent and dangerous docs are one thing - they should be re-trained if possible, and struck off if not. The point made by the book is that all good doctors make mistakes as well. This is part of human nature, the problem is that the consequences can be grave.
The thing is, is it any different to be treated by the best surgeon in the world, with the lowest complication rate (there is no such thing as no complications), or the worst in the world, with the highest? If you get complications, you are still in the same boat. But what if you get no complications from the shit guy? What if he's competent, but that the unit he works in isn't, because it has less support staff than another unit?
One or both of them might be competent or not. But the fact that someone suffers a complication is a far more difficult question to deal with - it may be that no one is at fault. Some of these things simply just happen.
Until loan-sharking is made illegal.
The difference is in scale only. They do exactly the same thing that banks do (save for the heavies that come round when you don't pay up...).
The earlier poster's entire point was the arbitrary definition of "illegally exorbitant". This is an imposed definition. That was his point. You have missed it entirely.
Legally, maybe; morally, definitely not piracy.
If someone in the US breeds mice, and by accident a strain happens to have similar or identical DNA sequences which give it the big C then is this a violation of patent? And what if the genes have never been sequenced, it's just known that they get cancer and are sold for research? If retrospectively we find out that they violate patents, it would see a bit stupid that the mice breeding (under only some human control and with the inbuilt unpredictability of fertilisation and DNA replication) could be illegal.
Patenting nature just seems very wrong to me. Just because I decode some of nature's best work shouldn't mean that I own it.
DOS anyone?
Soon he'll be a regular on /. complaining about spam with the rest of us.
On the other hand (as always) while I've got it up and running no probs (other than DL'ing one file) on every MDK distro since 8.0 (didn't try any previous), Red Hat, SuSE and Slackware weren't interested. I know you're meant to be able to, but when I have a distro that gets it going easily, why bother? Life's too short. It was, incidentally, easier than doing it on windows as well. (XP and 98)
While this by no means disproves the common "USB won't work in Linux" problems, it does show things are happening. It would be a shame though if all the other distros lost out because they didn't provide functionality that's been present for years in MDK's line-up.
Oddly enough, after the installation, I have trouble with the OS believing there is a network connection, but that doesn't stop it accessing the internet.. just denies ther's a connection present.
Worryingly enough, there are people who will not recognise this as sarcasm.
Most of the surgeons I have come across have been remarkably concerned about their patients - far more so than you would imagine. As I already said, it is quite possible that hips could be better, the problem is that developing them, for the tiny minority that need 'changeable' hips, would be prohibitively expensive. But add up coming up with an idea, and implementing it in enough people to give evidence that it's better (as you can see from the comment above, this might take 8-20+ years to prove), it is something most profit-oriented companies would rather not think about. The current lot do their job admirably, and beating them would be expensive, if not unfeasible. The 8-20 years R&D, and several, possibly litiginous, human subjects, are the problem. If they make a mistake with a prototype, the 50 or so people that they need (they might get away with 10-20) to prove their implant is better will have to be compensated if it is significantly worse. If it is no better, it's all wasted time and money. Animal studies would take just as long and are not directly comparible, the main problem is that human studies = liability.
Having some experience in the field, I would far rather be an engineer than a surgeon. These days, eveyone hates doctors.
I don't know how things compare in France - I imagine that they end up quite similar. The surgeons do a combination of what is best for the patient and what is practical (theatre time, available beds etc.). The companies that make the hips are marketing a product - maximise profit is their mantra. Neither are infallible, and while there are (more rarely than the media would like us think) unethical surgeons, big business and hospital management are far more likely to be the corner-cutting cost-cutters than the surgeon.