
Why Do Patients Stop Dying When Doctors Go on Strike? (2015) - shubhamjain
https://www.psychologytoday.com/us/blog/slightly-blighty/201510/why-do-patients-stop-dying-when-doctors-go-strike
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dustinmoris
> Doctors in the U.K. are considering whether to strike over proposed changes
> in their contracts, and they are marching in London as part of the protest.

> But when doctors strike, the scientific research shows that patients stop
> dying.

My wife is a junior doctor in London and she was part of the strike. As a
matter of fact, I've launched juniordoctorsstrike.co.uk as part of that
movement in 2015 to support the cause. In the specific case of the UK, a
junior doctor is anyone who _is not_ a consultant, so the contract changes
were applicable to not just new doctors (which is what most people would think
when they hear junior) but really any doctor who didn't bother to become a
consultant, even very very experienced doctors with many years of practice.

In the UK senior doctors (consultants) were doing crazy overtime to cover for
the (junior) doctors who were on strike, so effectively patients were being
seen by the most senior staff for a period of time. In that regard I'm not
surprised that if you throw an army of consultants for a very short and
limited time at all your patients that patient outcomes might actually
improve. It's needless to say that this crazy work amount for consultants is
unsustainable though. Take every "statistic" which you haven't forged yourself
with a grain of salt!

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anotheryou
Risky surgery can potentially kill you now and but safe you down the road.

You'd have to look just at people with planned surgery and those that would
have had surgery in normal times but didn't and than look at their mortality
over a timespan of years.

~~~
dwd
Right now is a good time to look into this with a lot of hospitals around the
world suspending non-essential surgery to free up resources deal with
COVID-19, without having to wait for the next strike.

Still, what do they need to learn - which surgeries have unacceptable risk vs
benefits and should potentially not be performed?

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Traster
I think it's really worth noting the sort of stupid science behind this. Yes,
deaths will decrease during a strike - because extra other staff will be made
available to cover the strike whilst non-essential work will be delayed until
after the strike. To make a real judgement you need to look at the statistics
across both a lead and lag period - the extra patients who died in the lead up
due to over-worked staff, the extra patients who died in the routine
operations that were displaced etc.

The _exact_ same issues are at the core of the source of the UK strikes
mentioned in the article:

> He said: ‘…three times less medical cover at weekends as they (doctors) do
> in weeks and that means that there's a 15% greater chance of you dying if
> you are admitted on a Sunday, compared to being admitted on a Wednesday.’

Because no one gets admitted to hospital for routine reasons on Sunday, so if
you're admitted to hospital on a Sunday it';s because your case is more
serious. If you make doctors do routine work on weekends you achieve 3 things:

1\. Doctors leave the UK to work for employees who aren't moronic psychopaths.
Driving down the level of care in the UK causing extra deaths.

2\. The exact same people who are routinely being admitted on wendesday are
being admitted on weekends too - so the death rate on wednesday admissions go
up whilst death rate of sunday admissions go down. With no net benefit.

3\. The government pretends it has reformed the NHS whilst dramatically
reducing its efficacy.

Note how, initially we talked about the _total deaths_ going down during
strikes? Becuase routine operations are cancelled? And then we talk about
death rate in relation to the weekend shifts? They are literally just two
sides of the same coin, want to complain about it being bad? Cite the rate!
Want to claim it's good? Well quote the total number! Perfect!

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eqvinox
> However, as soon as elective surgery resumed, there was a rise in deaths.

Well, duh? …

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vnbuddy2002
Very simple, because the doctors who record the number of fatalities also go
on strike. :)

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LatteLazy
Studies looking at Cardio ward outcomes when all the senior doctors go away to
conferences found a similar thing

[https://www.npr.org/sections/health-
shots/2014/12/22/3725083...](https://www.npr.org/sections/health-
shots/2014/12/22/372508398/is-your-heart-doctor-in-if-not-you-might-not-be-
any-worse-off)

One theory there was that juniors are more likely to "wait and see" while
senior (more confident) doctors pushed their skills too far but that's far
from proven.

~~~
anotheryou
Aren't chief doctors (or how they are called) also responsible for money and
biased that way?

~~~
dustinmoris
No senior doctors are not responsible for the money in the UK nor elsewhere in
Europe. Not sure how things work in the US, but given that the US thinks
automatic machine guns are normal to carry into a school I wouldn't look at
them and rather look at Europe ;)

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TurkishPoptart
A doctor has to be present to pronounce someone dead.

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olliej
Is this just another incorrect causation? Eg fewer surgeries == fewer deaths?

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doublesCs
> For five weeks, approximately 50% of doctors in the county reduced their
> practice and withheld care for anything but emergencies.

The answer is right here. Anything but emergencies.

