What I meant to say is that in the current structure it's like that and unfortunately very real. It can be changed, but probably at both a high cost and a profound cultural change. Your current social contract as a doc is
1. Do the job that is traditionally yours.
2. Handle all the impromptu alone because no one else will do it.
The second part is the problem, and is largely due to ressource constraints.
What's clear is that the system is already in pretty bad shape, so I'm just saying that the frontline workers are not a suitable target for pressure.
BTW your view regarding the nurse to doctor transition would have been ok 50 years ago. Nowadays, nurses are hyperspecialized in their own niches. If you meant to say "you should know how to make a bed before doing heart surgery", I heartily agree that it would do great good to everyone if docs were to experience what life is lower down the care ladder.
Thanks for replying this far after the life of the thread.
I was aware that nurses are far more trained today. But is their training that orthogonal to the doctors? I was thinking doctors starting with nurses in tandem with nurses allowed to operate more machines, do more radiology, etc.
Well, yes you can do that for some theoretical knowledge, but it wouldn't be very practical on the job because indeed, they are not the same jobs at all. The role of nurses is to handle the expected as efficiently as possible. The job of docs is to handle anything unexpected. That is why a wide education is necessary.
You may also be surprised by the fact that specialist nurses are well paid and would often never want to "upgrade" to being a doc, precisely be cause of the additional constraints. Finally, the ego of specialist nurses rivals that of docs, and they are even stronger unionized.
I don't think it's really possible to keep the same quality of care for cheaper by changing education because armies of residents and fellows are effectively doing slave labor and you'd have trouble finding cheaper and more efficient than a highly-trained slave. In my opinion, well applied technology is the only long term solution.
1. Do the job that is traditionally yours.
2. Handle all the impromptu alone because no one else will do it.
The second part is the problem, and is largely due to ressource constraints.
What's clear is that the system is already in pretty bad shape, so I'm just saying that the frontline workers are not a suitable target for pressure. BTW your view regarding the nurse to doctor transition would have been ok 50 years ago. Nowadays, nurses are hyperspecialized in their own niches. If you meant to say "you should know how to make a bed before doing heart surgery", I heartily agree that it would do great good to everyone if docs were to experience what life is lower down the care ladder.