This weekly roundup thread is intended for all culture war posts. 'Culture war' is vaguely defined, but it basically means controversial issues that fall along set tribal lines. Arguments over culture war issues generate a lot of heat and little light, and few deeply entrenched people ever change their minds. This thread is for voicing opinions and analyzing the state of the discussion while trying to optimize for light over heat.
Optimistically, we think that engaging with people you disagree with is worth your time, and so is being nice! Pessimistically, there are many dynamics that can lead discussions on Culture War topics to become unproductive. There's a human tendency to divide along tribal lines, praising your ingroup and vilifying your outgroup - and if you think you find it easy to criticize your ingroup, then it may be that your outgroup is not who you think it is. Extremists with opposing positions can feed off each other, highlighting each other's worst points to justify their own angry rhetoric, which becomes in turn a new example of bad behavior for the other side to highlight.
We would like to avoid these negative dynamics. Accordingly, we ask that you do not use this thread for waging the Culture War. Examples of waging the Culture War:
-
Shaming.
-
Attempting to 'build consensus' or enforce ideological conformity.
-
Making sweeping generalizations to vilify a group you dislike.
-
Recruiting for a cause.
-
Posting links that could be summarized as 'Boo outgroup!' Basically, if your content is 'Can you believe what Those People did this week?' then you should either refrain from posting, or do some very patient work to contextualize and/or steel-man the relevant viewpoint.
In general, you should argue to understand, not to win. This thread is not territory to be claimed by one group or another; indeed, the aim is to have many different viewpoints represented here. Thus, we also ask that you follow some guidelines:
-
Speak plainly. Avoid sarcasm and mockery. When disagreeing with someone, state your objections explicitly.
-
Be as precise and charitable as you can. Don't paraphrase unflatteringly.
-
Don't imply that someone said something they did not say, even if you think it follows from what they said.
-
Write like everyone is reading and you want them to be included in the discussion.
On an ad hoc basis, the mods will try to compile a list of the best posts/comments from the previous week, posted in Quality Contribution threads and archived at /r/TheThread. You may nominate a comment for this list by clicking on 'report' at the bottom of the post and typing 'Actually a quality contribution' as the report reason.
Jump in the discussion.
No email address required.
Notes -
I don't really see why you'd think doctors are evil really, though of course it's hard to make a man understand something when his salary hinges on him not understanding it.
US doctors are far more professionally organized and cartel-like than their peers abroad, they command significantly higher wages and have more to lose. Even then, the medical system is no insanely sclerotic and dysfunctional there that I doubt it's doctors sucking the surplus out of it.
In contrast, Indian and British doctors, the two nations I'm most familiar with, are far less militant in their self protection. The former are barely fending off PAs and NPs, and in India there's a tide of homeopathic and ayurvedic quacks lovingly recognized by our governments under AYUSH.
The Brits have shit salaries, thanks to being employed by a monopsony in the NHS. Indian doctors make poor salaries because the country itself is poor. Neither are ripping off the locals.
What the US does suffer from is a sense that nothing but the best will do. Barring a new midlevels of their own, often sneakily employed unless the patient asks for a doctor instead, there's a sense of sacrilege in accepting care of 80% the quality for 50% the price.
Of course, in India, it's accepting hired monkeys in lab coats that know enough to dole out paracetamol, so something like 30% the quality for 50% the price. But it works, since the typical Indian isn't very discerning.
Consultants make that much about 7-8 years into training, after 4 years of med school and 2 years in the Foundation program. From my understanding, hanging around on subs for British doctors for several years, people feel shafted when they can quite easily emigrate to other Commonwealth countries and make a great deal more, while also dealing with less antisocial hours, more time off, and coverage of the thousands of pounds in fees for mandatory exams needed for career progression. No faffing about being chucked from one end of the deanery to another to boot.
In addition, the perception is that they could have made far more money at the entry level and above by going into something like finance instead of medicine, which I'm given to understand is the one domain in the UK that makes a decent chunk of dough.
In addition, the Government as a monopsony employer has enforced sub-inflation pay raises for over a decade, while resisting pay restoration efforts, leading to the recent strikes. Further, doctors can make a great deal more outside the NHS working for private hospitals, with the only reason to work in the NHS being that your career progression hinges on it. Once again, the monopsony employer suppressing wages..
And of course, wages for entry level doctors in the UK are abysmal, especially given the amount of time spent in training and their responsibilites. A PA can make 45-50k while having fewer responsibilities than an FY2, the latter making around 35k. They can't even prescribe!
As such, a great number of the locals are fleeing to fairer shores, and being replaced by IMGs like yours truly.
You aren't doing yourself any favors by comparing yourself to the 1 well-compensated profession that even practitioners themselves will admit is a scam.
I do it because it is provocative. The main point alludes to the eternal tradeoff between protecting your paycheck and doing good in the world. Doctors are ideal bait, because it is the one profession which has an air of selflessness, and sets implicit expectations of reverence from the common man.
Agreed. My fellow Indians doctors do not seem to enjoying the same luxuries as American doctors. If anything, being a doctor in India sounds like the worst of both worlds.
I think you may have misread that - consultant doctors =/= management consultants. A "consultant" in medicine referrers to a specialist who has completed training.
More options
Context Copy link
More options
Context Copy link
I'm only conveying what I've heard from lurking around, given that they're in the midst of industrial action, I suppose they're hyping themselves up as much as feasible.
The bigger issue is a massive decrease in QOL of doctors in living memory. They need a ~40% pay raise to restore their pay to 2008 levels after adjusting for inflation, for the same amount of work. That's on top of dealing with crap that doctors from other countries largely don't worry about, like rotational training making it very hard to buy a house or maintain a relationship.
I think any set of doctors would be pissed if they saw their wages being chipped away at that pace, and it's not a historical phenomenon, it's well within living memory. That's leaving aside how much less respect they get compared to their foreign peers, especially with a nominally flat hierarchy of all health workers. I've read about nurses making comments to junior doctors without issue that would have had them chewed up anywhere else.
Still, the UK has a great deal further to fall before it becomes worse than living in India, so it's a largely moot point from my perspective. If I get some rather distressing bureaucratic issues dealt with, I myself might CCT and flee, but that's assuming a business as usual economy, which it very much isn't going to be. At that point, simply tolerating that shit till I have citizenship in hand, something far more valuable than wages at that point.
Yeah... every once in a while I wonder how does anyone still want to be a doctor. I probably couldn't do the job even if I wanted to, and even if I could, the responsibility sound nerve-wrecking, and the compensation just doesn't seem worth it.
More options
Context Copy link
More options
Context Copy link
~$200K CAD would AFAIK be pretty normal for a Canadian GP who doesn't run appointments factory-style, unless things have drastically changed in the past few years. Specialists do make more, and some GPs run checkup mills which can be quite lucrative (as they are compensated per visit) but seems stressful to me -- I don't know that they make "a great deal more" $100k sterling equivalent though.
More options
Context Copy link
And a software developer in UK makes less about 40k after 3-5 years of uni and a couple of years of work. A senior developer with who knows how many years of additional training makes about 50.
Doctors are extremely well compensated and have unparalleled employment security.
It's probably true that people can emigrate to get higher salaries but that is even more true of other professions.
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link