Nursing, like many other job categories, has had credential creep (i.e. employer preference for BSN over ADN in the US, and similar in Canada). OT and PT are other examples.
When you have a system that gets paid on the cost-plus basis, there’s no incentive to reduce cost, regardless of need.
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I would not assume that having a specialist for a common condition that primary care physicians see lots of every day adds any value to me as a patient (even though it may cost both me and the overall health care system more). A disadvantage is that multiple physicians can prescribe care without coordination with others, resulting in unwanted interactions or polypharmacy issues.
But then demand for specialists means higher pay for specialists, encouraging more debt-burdened medical graduates to try for the higher paid specialties rather than common primary care specialties. I.e. the pressure for perfection in the face of competition continues even after one gets into medical school.
In the US, there is a slight degree of specialization among primary care physicians. “Family practice” physicians are primary care physicians for all ages. “Internal medicine” physicians focus on adults, while “pediatricians” focus on kids. Would it be correct to assume that primary care physicians in Canada are all or mostly equivalent to “family practice” physicians in the US?
I’d bet that ChatGPT/GPT-4 can already (or will soon be able to) provide as good an advice as multiple physicians/specialists for consulting purposes, if the patient knows how to ask the right questions and follow-up questions.
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I’m not at the point where I need statins or care. I like to hear what various specialists have to say on preventative measures. I can only talk IRL with my doc friends up to a certain point before it gets tiresome. So yes, I am to blame for driving costs up. But I find that for me, anyway, talking to specialists calms me down and makes me stick to my preventative regime better.
Yes, there are family physicians in Ontario who deal with everyone. There are pediatricians (not sure what they do there besides deal with the very ill kids) and internal medicine physicians (only met 1 Canadian IM in my life and he was an academic).
P.S. I cannot wait for Dr ChatGPT and run the same questions to Dr Chat and my RL human docs.
Knowing what questions to ask goes a long way to finding the answer, and is much of the value that those in skilled trades and professions (including medicine, but also lots of other things) bring that is worth paying for.
So if AI is to become as good as or better than your primary care physician, it needs to be able to figure out what questions to ask when a patient has some poorly described symptoms that are bothersome.
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Yes. But given the millions of iterations that it can run, I bet the AI is going to be more consistent in the long run.
My doc friend says that he can’t see some people interacting with AI over a human. I suppose some (like me) may prefer it. You can ask the same question with a tiny variation and check the difference in response.
Lower abdominal pain every night right after dinner for 2 weeks.
Lower abdominal pain every night around 10pm for 2 weeks.
Pain going down stair case intermittently for months.
Pain going down stair case weekly for months.
That kind of thing that would exasperate a real human.
One of the first categories of new jobs created by technologies like ChatGPT is the so-called “prompt engineers”. They’re already in demand and well paid.
There’s no reason why AI can’t ask questioners to clarify the intent of their questions. Being able to probe in the other direction is surely in the work.
I can see why… here on these forums, supposedly smart and well informed students and parents are often seemingly oblivious about how to find answers to common college questions:
- Financial aid? Search for “[college] net price calculator”.
- Class sizes? Search for “[college] class schedule”.
- Pay levels of recent graduates? See College Scorecard and check if the college’s career center web site has post-graduation survey results.
- Calculating unweighted GPA? Apply the concept of average from math class.
Of course, there are also cases where students and parents do not realize that there are some questions that may need to be asked, such as secondary admission to major requirements, or weed-out / progression requirements for students directly admitted to major.
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Well, if I had a dollar for every time I did not know what question to ask when I didn’t know something.
The benefit of AI is time. It’s somewhat stressful for me to go to see a doc because I’m busy thinking/googling about how to phrase my problems so I’m not dismissed. They have 15 minutes max to listen to me, and of course, if I am inconsistent, I worry about that.
To that end, I spend endless hours googling how to phrase a symptom so I am not dismissed. This kinda sucks. Wouldn’t it be nicer to have a patient AI, so I can pause, think about it, and come back to it in half an hour. Basically have AI medical care 24/7. Or for hours through a day. Or whatever.
Knock wood - nothing wrong with me. But I do consult with specialists as I see “normal” aging processes play out in my bloodwork.
People, let’s not go off on that tangent. Use of AI for basic medical treatment is a great topic, and worthy of its own thread. However, that is not the topic of the thread, so let’s get back on track…
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It might, but good Drs ask questions.
I went to a private high school like this. The counselor there actually discouraged me from applying to a school that I really wanted to go to and I naively listened to him. I didn’t even apply. I was very happy with where I went to school but I wish I had ignored him.
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It’s bad enough when a parent isn’t supportive, but to put additional pressure on a child is just horrible. I don’t want to use another word because it is horrible. The reasons for this could go from parents being overly ambitious to them trying to re-live their own life through their children. Regardless, I feel strongly for these kids; imagine all the stress they have to deal with.
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Absolutely true. When I was in school, we had no smartphones, no computers, only 3 channels on TV. Either you played outside or read a book. Or hung out with friends and talked, face to face. Many more distractions now, so not surprised at all that reading levels have dropped.
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You are not alone in that fight. At the risk of rubbing the mods the wrong way, I’m very happy that my kids didn’t know about this place when they were going through the process (and they still don’t). This is the place that will convince a kid, because data, that if you major in biology you’re going to need to live with your parents, if you attend a LAC or major in the arts anywhere you’ll be serving coffee the rest of your life, if you major in engineering you’ll retire in your early 50s, and if you get into and out of MIT you’ll be eligible to run the universe. Nuance is in scarce supply here. I mean, there’s data and then there’s how you’re going to go live your life. My financial advisor at Morgan Stanley spent most of his youthful energy playing hockey (making it close the NHL) and just got by academically at his Canadian university. He makes a boat load of money. There are plenty of ways to get there.
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A high profile athletic career has been a ticket to finance careers for decades.
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I think this is particularly true for those young people who want to live in coastal destinations of choice. And before we all say in unison, “life’s tough. move to Michigan,” remember that a lot of these kids grew up in these areas, so it’s not like an extended European vacation … it’s home. We see this a lot in Seattle.
I do have one solution for those kids that will help alleviate the pressure to be perfect. If you want to earn enough money to live in, say, Seattle, and your parents live elsewhere, go to your local state school (needn’t be a flagship), major in accounting, get solid grades (you don’t need to be the kid who as an undergrad published three papers and solved a riddle that has perplexed the world since the dawn of time) and land at a Big 4. Work your tail off there, fall in with a partner who likes to mentor, and absorb like a sponge everything you learn from client audits and make as many connections there as you can. Go in-house (the opportunity will be there - trust me) at around year 5 (mind you, you’ll be making six figures+ all along the way) and work your way up through finance or ops.
Trust me on this. KPMG hires accounting kids with a below 3.9 GPA from all kinds of schools. The Seattle office is crawling with kids from Western Wash University, Seattle Pacific U, Seattle U, Gonzaga, etc.
If the kid meets and marries someone on the same or similar track, they’ll be more than fine.
It’s not Goldman Sachs, but these kids can make the C suite without a Wharton MBA, and even if they top out as director or junior VP level people, they are getting paid.
This all assumes AI doesn’t do away with their profession, but that’s probably a ways off.
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I think OP defines perfectionism in the context of school grades, which, as we all know, may or may not directly contribute to earning powers.
Is there necessarily a problem if a kid is a perfectionist? I wouldn’t think so. If the kid isn’t, but the parent is, there might be a problem if the parent tries to force their kid to be a perfectionist.
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True, and because I’m not Canadian I can’t say whether having a solid Junior Hockey career gave him anything in the way of connections or entre into finance. I really don’t know. What he’s told me sounds like the stereotype (made for TV) story of a rural Canadian kid who grew up on a farm in Saskatchewan (sp?) and made it out of there on hockey. His siblings are still stuck in their small home town.
I think with my guy the hockey may have led to an intro or something … he eventually wound up in university, something his siblings didn’t do. But in his case the main part of success is being willing to work in sales and build a book. A lot of kids want to be on the brain end of the operation. My guy is not charting new territory in investment theory. I don’t think he would have ever been ibank material. But he’s smart enough and is good with people. I guess that was my point, I think, in bringing him up.
But I agree with you. Athletics, curiously enough, really can open doors. There was a whole separate network at two of the schools my kids attended the gatekeeper of which was the AD. Former athletes like former athletes I guess. I don’t understand the thought process myself. I am a former athlete, and I really don’t care.
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