<story><title>How Being a Doctor Became the Most Miserable Profession</title><url>http://www.thedailybeast.com/articles/2014/04/14/how-being-a-doctor-became-the-most-miserable-profession.html</url></story><parent_chain></parent_chain><comment><author>tdees40</author><text>The biggest problem is just the AMA.  They limit the number of doctors in America, so there are just too few.  This drives up the salaries for the few doctors who live the tell the tale (but certainly don&amp;#x27;t want to go into primary care, when other more lucrative jobs are on offer), and drives up the hours for everyone.&lt;p&gt;Making it easier to become a doctor would improve things immediately (especially given the recent research that makes it clear that nurse practitioners do just fine).</text></comment>
<story><title>How Being a Doctor Became the Most Miserable Profession</title><url>http://www.thedailybeast.com/articles/2014/04/14/how-being-a-doctor-became-the-most-miserable-profession.html</url></story><parent_chain></parent_chain><comment><author>eldavido</author><text>This is completely a story of industry structure and bad incentives, and how people react to them.&lt;p&gt;Currently, in the United States, we believe all of the following things: (1) Human physicians, are the only qualified parties to diagnose, treat, and&amp;#x2F;or recommend courses of action related to health (not nurses, physician&amp;#x27;s assistants, computer programs, etc.), (2) everyone has a fundamental right to healthcare, (3) health professionals must undergo expensive, lengthy, difficult courses of study and training, and (4) we reimburse for procedures, not pay for outcomes.&lt;p&gt;Given these incentives, it&amp;#x27;s not hard to see why doctors are some of the most overworked, stressed-out, and generally miserable professionals out there. They&amp;#x27;re at the nexus of a crushing conflict between keeping people healthy, a management system that demands more revenue (and remember that revenue=procedures, because we reimburse for procedures, so the only way to increase &amp;quot;productivity&amp;quot; is to do more, faster, with fewer breaks and longer shifts), and a legal regime which mandates DOCTORS perform procedures, and only after a lengthy course of study.&lt;p&gt;I believe the way forward is to shift the discussion away from procedures and more toward outcomes, and give medical professionals more operational and financial freedom to run their practices using tried-and-true free-market principles. I believe this outcome is inevitable, but will take a decade or more to surface, because it requires major shifts in how doctors and insurance companies think about billing, greater human trust in computers and recommendation systems, and a collective realization that the current state of healthcare is untenable.</text></comment>