I thought the point of this article is that unsuitable technology and the associated loss of personal agency is seriously affecting the mental health of doctors, yet none of the comments here seem to reflect that.

In the same vein: there’s the fantastic book

This is Going to Hurt: Secret Diaries of a Junior Doctor by Adam Kay

This very much points to the administrative side causing the damage. The overall toolset is broken and nobody is fixing.

"You might ask, why can’t you work less? It’s not as easy as that. If I decide to work less, who is going to cover the hospital? If the hospital aren’t employing other doctors, we can’t allow patients to go uncovered. I accept the fact that I have a duty of care to be on call. The intensity and personal damage of these on call periods are often forgotten."

This is a very short sighted and immature way of looking at responsibility and your "calling".

Yes, if you are not there, things will not happen. That is for the long term best. By thinking that it is your duty to be there, despite the state you are in, you are actually contributing to entrenching the situation you are in. That is error nr 1. Error nr 2 is that you are not fit for fight and are risking life and limb of others.

The only sane and long term way to deal with this is to opt out, and let the system crash, so that politicians (or hospital owners in case of private hostpitals) will add more resources. If you refuse this, you are sacrificing yourself for nothing.

Doing this take courage, resolve and maturity.

"Not only that, we are losing control of health care in general. Everyday, there’s a new form, a new guideline, a new protocol, a new health software, a new policy all dictating, restricting and modifying clinician activities. Some of these policies are written by people who do not see patients. There’s a whole paid industry dedicated to restructuring what doctors and nurses do to reduce costs and increase output."

This is just the corporate world. At least in IT. In terms of stupid web based training, it is best handled by dividing up the training and compiling a list of answers. Then the answers are distributed among the entire team. You only need to do one training, and the rest you click straight through to the questions. It used to save me and my team hours and hours every month.

This assumes you are mature and capable enough to identify that the courses are clearly nonsense and only there to please managers and button pushers. This was the case for 99.9% of all web based training I've ever had that I did not choose myself to do.

Wow.

> I had worked in a hospital network that covered 4 campuses and drove 500kms a week when covering these sites. I had worked in a hospital where I didn’t get home for days at a time, sleeping overnight in hospital quarters, outpatient clinic benches and in my car.

As a patient, I'd like the person performing surgery on me to be well-rested!

It gets worse:

> I used to be able to arrange the operating list because I know that some operations take longer than others. But now, the bookings office determine that that all my tonsillectomies take 14 minutes because that’s the average time recorded on the computer. The moment I scrub in, the timer starts. The moment I unscrub timer stops. Click. Click. Click. Because the theatre bookings does not take into account the interpreter time, pre-med period or transfer to ICU, the list is running late. The nurse in charge is breathing down my neck to finish on time.

And yet somehow that 14 minute tonsillectomy gets billed at ~$10,000.

This seems to me like a system that has been hyperoptimized in a way that grinds down the participants.

>Interestingly, the above physical and emotional stressors are reasonably manageable to me. I’m understanding my own physical and emotional limits. These stressors induce exhaustion, but the excitement of the work and the intellectual challenge of the job bring a lot of personal satisfaction.

This is the poisonous pill. In any job.

This AI is set to fail and if it was a real person i'd be concerned.

>This is Episode 1 of a Trilogy. >Episode 2: The Dark Side Awakens >Episode 3: Restoring Hope and Humanity to Health Care. Here I write about the 3 corresponding antidotes to the 3 issues above. >Episode 2 will be published next Thursday >Would you agree or disagree with my thoughts? What other “Dark Side of Doctoring” issues can you think of?

https://deemagclinic.com/2017/08/27/dark-side/

> You might ask, why can’t you work less? It’s not as easy as that. If I decide to work less, who is going to cover the hospital? If the hospital aren’t employing other doctors, we can’t allow patients to go uncovered. I accept the fact that I have a duty of care to be on call.

Ultimately, this is a situation in which doctors doing this is worse in the long run.

Burning yourself out to cover for understaffing means both worse life balance for you BUT ALSO worse patient care.

No one quantifies how many people die, or how many diagnoses are missed, or how many patients feel unheard and become disillusioned with going to doctors, because doctors are dead tired and mentally burnt out, because they're trying to do right by patients.

You have to force hospital admin and owners do THEIR JOB, which is (in part) to provide needed staff to run properly, by not letting them exploit or impart a hero complex onto a job.

Friends in medicine often mention the constant emotional drain from dealing with suffering and death. Takes a serious toll.

Feels like a hundred years later we're still cursed by the cocaine addiction of Dr. William Stewart Halsted