Socialized Medicine From One That Has Experienced It

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I’m not a fan of socialized medicine. I firmly believe that health care is a privilege and not a right. Many people — including uninformed pre-meds with high hopes of saving the world — think socialized medicine is the best thing since sliced bread.

Doing some reading today, I came across a reply to an article on $8 per gallon gasoline. Here’s what this person had to say, emphasis mine:

“You have never lived in a country with social medicine. I have and it does not work. It took me six months to find a doctor in Canada… everyone’s shining example of a great social health care success story. I was told by their social medicine govt office to call all of the doctors in the phone book and I might get lucky. I tried to get my knee repaired (ACL reconstruction) however, the waiting line was too long ( 15 months) so I went to the states and had it done in two weeks. I was in England and hurt my knee and could not get a doctor to prescribe pain medication nor get me crutches to walk. Montreal has five major hospitals all with CAT Scan Machines…4 out of 5 broken and the fifth with out of date software. Keep in mind social medicine is not medical care on demand, they prioritize and categorize, my age, health and whether the surgery or care is needed. What you don’t hear is the number of Canadian citizens that come to the states to get medical care that they cannot get in Canada. Additionally, the average monthly tax rate in Canada of my peers was close to 50%.”

Does this sound like a great system to you? People need to wake up and realize that socialized health care is not equivalent to easily-accessible, cheap (or free) medical care on demand. This is just one of probably many examples of why it doesn’t really work.

56 Hour Work Week Is On The Horizon

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The Committee on Optimizing Graduate Medical Trainee Hours and Work Schedules from the Institute of Medicine in Washington, DC is making their final report in nine months and recommend decreasing maximum work hours from 80 to 56 per week. That’s the inside word, anyway.

All I can say is about f’ing time.

It looks like strong support for the care of patients as well as the care of those providing that care is fueling this fire, and I believe the old-schools are probably shaking in their boots right now. This rule change looks to be garnering quite a bit of support.

Additionally, training programs consistently violating the rules as if they’re part of some game probably have a lot to do with the proposed rule changes as well:

Furthermore, we know that despite rules being put in place in 2003 to govern resident work schedules that the culture and traditions remain very strong. What we need are some levers—maybe even some financial levers—to make it easier for people to do the right thing.

Like I said in a post way back — it’s all about the Benjamins. On one hand this could mean yanking funding and even hefty fines (i.e. hundreds of thousands to millions) for training programs that don’t play nice this time around. On the other hand, “levers” could also mean an increase in funding to those programs who are rule-abiding citizens. Either way, it’s about f’ing time.

The primary task of this committee will be to focus on four areas:

  • Synthesis of the current evidence base on graduate medical trainees hours and works schedules and their impact on safety.
  • Identification and development of strategies, practices, interventions, and tools that can be used to implement reasonable work hours.
  • Analysis of both the potential benefits and harms of updating work hours and schedules.
  • Short- and long-term recommendations for action by various stakeholders and interim strategies and policies for implementing these recommendations.

According to the thread at SDN, the only problem yet to be tackled is length of training. But, it’s a big one.

I’d say that many people are willing to put up with the extra-long work hours in order to be done with an Internal Medicine residency (for example) in three years. However, there are undoubtedly countless others who would prefer to live a more “normal” state of being and extend training by a year or two.

I guess it really all boils down to how much you really want it, but I see this coming out into the light sooner rather than later. No matter how you slice it, “only” 80 hours per week is the biggest joke I’ve seen in a long damn time.

The Golden Weekend

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“What’s a Golden Weekend?” you ask. Let’s play a game.

  • It consists of 48 hours of time away from work.
  • Saturday and Sunday are the typical days included in the Golden Weekend.
  • Many people look forward to the Golden Weekend all week long, every week.
  • Medical students and residents look forward to — and receive — the Golden Weekend only once per month, on average.
  • A Golden Weekend is a weekend that most “regular people” experience, on average, four times per month.
  • The Golden Weekend can be used for short-term travel, bar-hopping, hiking, or just lounging around the house and sleeping.

Give up?

The “Golden Weekend” is a term coined by residents. It typically refers to the weekend in which you have both Saturday and Sunday free from all clinical duties. Since many residents only get one weekend per month completely free from the hospital, the term is derived from the notion that “it feels golden to have your entire weekend off.”

Only in medicine.