I don't work in the healthcare industry so I have no skin in the game, but in what situations do you consider labor cartels ok because unions are exactly that and many people here seem to advocate them. Becoming a doctor from what I have read sounds like a horrible return on investment: You have to delay real wages for like 8 years while you get educated, those 8 years make you massively in debt, once you become a doctor, you have to pay off those 8 years of debt while also paying massive insurance rates. I'm not suprised doctors are trying to secure some wages after 8 years of investing in themselves while going massively in debt.
I doubt many on HN of all places are for legally mandated unions, which are the ones that produce true cartel like behavior. Most unions maintain authority through their collective bargaining alone - to abstain from the union would mean the loss of most of your workforce, and thus you must negotiate with the union.
Except if you want to call unions cartels because they negotiate on behalf of their members with employers than anyone trying to barter in business is engaging in cartel like behavior. Its deconstructive because in practice unions only exist to counteract the power imbalance between worker and employer. A cartel in business forms not to counteract power imbalance through collective action but to monopolize existing power.
You might call those origin points irrelevant but they make the world of difference to me. In the absence of unions labor is almost universally exploited. In their presence, businesses are hopefully and sometimes forced to bargain on more equal footing. Thats a net benefit. A business cartel likewise exists to imbalance what was closer to equilibrium and thus is a net negative.
The 8 years could be streamlined but it's setup to weed out many and tire out the remaining. Many of the brightest most curious people get turned off by the process the people that remain are the ones who could stand the beatdown. Then they get out start working and have to see 25,000 people a year (100/day) as a gp.
There is a huge burnout process going on. I see so many doctors try to make a business on shark tank/dragons den work or they try to become media personalities.
Many seem stuck because the job isn't what many would expect. They have invested heavily time/effort in study, they have high debt and they have increased expectations from family/community.
Personally I'd rather they set up a more sustainable training approach - I'm not overly keen on having a doctor who's been "tired" out. I've seen a junior NHS doctor treating a partner in such a state of tiredness that they had to rely on mnemonics and tell us the number of things they'd be checking so that he didn't forget two minutes later and miss any out.
Peter Attia discussed on his podcast a time when he fell asleep and fell on top of a patient while operating on them during his residency. Pretty insanely bad system.
> The 8 years could be streamlined but it's setup to weed out many and tire out the remaining.
Undergraduate medical education in Europe is commonly five or six years so yes, it could really be streamlined. If summers weren’t taken off you could fit medical school into four years. “Weed our and tire out” makes it sound like there are people who drop out of medical school when it barely happens at all.
In Canada .5 dropout, in the US 3 1/2%, in the UK 5%. In Canada there are very few spots so the effort to get in and have a way to pay for the education happens before. Once you are in the pressure to remain is extremely high. But 11% still seriously think about quitting.
The decisions and effort need to be put in early in life. Very few go to college and decide to become a doctor. They usually have gone to college to become a doctor and select schools/programs based on that. For some it starts earlier than highschool.
When you finally become a doctor after the lifetime of work the job may not be exactly what was envisioned but it is too late.
Offtopic somewhat:
I know of smart people who decided to started programming, drawing/painting, inventing, writing, practicing law after age 35 and are enjoying careers. I know of no doctor ever.. is medicine that difficult for someone past 30?
