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Culture War Roundup for the week of December 9, 2024

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and they have incredible status to boot

I don't think this is true anymore. Anti-doctor viewpoints are super common right now. The left and the right hate us. Corporate media blames us for cost overruns. We aren't independent anymore. Patients murder us and it doesn't make the news. We get threatened all the time at work and the police and the hospital both shrug, even in places where there are specific laws against that.

Look at the tone here. Sure I'm not a perfect communicator but every time I try and refute lies about the AMA I get buried in downvotes, the "doctor bad" and "doctor is the problem" memes are rampant, and that extends to general society.

Not saying it isn't true, just saying that people absolutely feel that way.

For a practical example - you used to be able to get laid or find a partner b/c you were a doctor. Doesn't really work any more.

Fwiw, I appreciate your posts, but don't fret too much about downvotes, that way lies madness. As much as we wish people would vote according to how well an argument is articulated, whether they agree with it or not, I believe most people still use it as an "I agree/disagree" button, and a substantial fraction vote in a reflexively tribal manner.

That being said, while I believe you that being a doctor is difficult and not as rewarding (financially or emotionally) as it might once have been, it's still really hard to convince me that being one of the 4% or so sucks as much as you imply. We could probably do all sorts of reforms that would improve doctor QAL, but some of those would also reduce doctor remuneration, and for some reason doctors seem to prefer the high barriers to entry and what amounts to years of grueling hazing before you're in the money.

I don't think the hostility you describe is some new wave of anti-doctor sentiment. It's a general breakdown in social norms making it more dangerous to be a bus driver or airline attendant or a counter person at McDonalds too. Most hostility about the health care industry is not directed at doctors. It's the hospitals, the front offices, and the insurance companies. And probably nurses take the brunt of patient hostility more than doctors.

I don't think I disagree with any individual thing you said there - downvotes aren't representative and shouldn't be over analyzed, the job and pay are worth it (but less so than the past), people are meaner and angrier in person (to say nothing of online) these days, and so on.

That said - the excess of disagreeableness and decline of respect for institutions and expertise is real (everywhere and sometimes deserved). It's extremely noticeable in our jobs though, because most of life and health takes place outside of the hospital so we can easily see when people don't listen (and come back or die) or make a mess during their stay/visit.

Our oldest can tell us how different it was in Ye Olden Days, or if we work in settings with radically different populations we can see the gap (Vets).

These days we see more and more patients doing things like walking away from treatable cancer to ending up terminal on homeopathic arsenic from someone who is legit licensed in Oregon because that's a thing they do. While I'm not immune to slinging mud at times...people yelling at me on the internet scratches the fundamental same itch writ small.

What bothers me a little more is when people don't realize the decline, especially when it is the respectable types, because of course that hurts more.

Yes I want to be respected (who doesn't?) but it's so intrinsic to the job for us. Yeah its kinda funny when I whinge about it being harder to pick up women as a doctor, but patients shooting their doctors (real but rare), people demanding things that are dangerous to themselves and others like antibiotics for a virus (common as all hell and a problem but individually small potatoes) to the expansion of midlevels because people don't realize how much worse they are (metastasizing everywhere and I'm tired of seeing my patients and friends end up with bad outcomes from it)...these things are real and bringing my end of things closer to collapse.

Like much of everyone's current ills I don't know what the solution is, but I will get on the soapbox and mumble a bit.

And on traditional and all together saltier note, since I was a young intern on call at one point in the distant past: yes nurses get it worse from patients but they totally deserve it.