A doctor has responsibility over many more patients. A doctor’s competence is more complex, so he has more ways to screw up. A doctor can make more autonomous decisions, often makes them alone, and can’t as easily ask help from others. He also leads a team, so he doesn’t have to execute all his mistakes himself.
A doctor has responsibility over many more patients, often an order of magnitude more
I disagree with your implication. Most doctors and nurses are responsible for specific treatment aspects of a few tens or hundreds of individuals. A small minority of doctors influence larger numbers (e.g. department heads), but even then many of their instructions are carried out by nurses and junior doctors.
A doctor’s competence is more complex, so he has more ways to screw up.
Nurses who administer treatments have ways to screw up that are not available to doctors who merely select those treatments. A doctor can order a harmful procedure; a nurse can actually administer the wrong drug by mistake. A doctor can make a mistake in surgery; a nurse can make a mistake in intensive care.
I think empirical data is needed to elucidate the amount of mistakes (or “responsibility”) owned by doctors and nurses. It’s not something that can be clearly deduced from first principles.
You disagree with the implication or the claim? Do you disagree with it completely or do you think it’s exaggerated? ETA: It seems it was exaggerated, but right. There are about 3 nurses per doctor on average in OECD countries.
but even then many of their instructions are carried out by nurses and junior doctors.
That’s one of the key points I made. A nurse can’t make other people carry out mistaken orders. A person carrying out a mistaken order isn’t necessarily incompetent, although in easy to spot cases they are.
Nurses who administer treatments have ways to screw up that are not available to doctors who merely select those treatments.
Sure. A doctor has hundreds (or thousands) of diagnoses and medications to choose from. That makes me pretty confident that he has more options for fatal mistakes, and that the probability of doing the right thing is much lower.
I think the more difficult question is what constitutes incompetence, and what levels of incompetence are comparable in nurses and doctors. I strongly suspect that our main disagreement comes from this aspect.
I think I agree what Joshua said here so debating this point much further isn’t of much interest anymore.
You disagree with the implication or the claim? Do you disagree with it completely or do you think it’s exaggerated?
The claim was that doctors are responsible for more patients. I’m not sure that is correct; your link about there being more nurses says,
Nurses play a critical role in providing health care not only in traditional settings such as hospitals and long-term care institutions but increasingly in primary care (especially in offering care to the chronically ill) and in home care settings.
Anyway, what I meant by the ‘implication’ (should have elaborated, sorry) was the implicit claim that because doctors have responsibility over more patients, that means they can do more damage if they screw up. But even if a single doctor does more damage than a single nurse (and I’m not sure of that), 5% of doctors screwing up would still do the same amount of damage as 5% of nurses screwing up.
A doctor has hundreds (or thousands) of diagnoses and medications to choose from.
A doctor knows thousand of diagnoses but for a patient complaining of knee pain most of them are completely irrelevant and would never be diagnosed by mistake.
Also, a nurse can administer any treatment a doctor can prescribe, so nurses also have theoretically thousands of medications to administer by mistake.
Finally, most nurse also has a range of mistakes, having to do with physically taking care of the patient, which aren’t available to most doctors, who don’t perform dangerous procedures every day.
even if a single doctor does more damage than a single nurse (and I’m not sure of that), 5% of doctors screwing up would still do the same amount of damage as 5% of nurses screwing up.
Certainly true but not relevant.
A doctor knows thousand of diagnoses but for a patient complaining of knee pain most of them are completely irrelevant...
Fair enough. We could continue this forever, but I wouldn’t find that especially rewarding. I quote myself:
I think the more difficult question is what constitutes incompetence, and what levels of incompetence are comparable in nurses and doctors. I strongly suspect that our main disagreement comes from this aspect.
Which requires more incompetence: making a wrong diagnosis and prescribing the wrong medication, or giving the wrong medication, when you’re given the name of the medication? I’d say the latter, and so they wouldn’t be comparable.
A doctor has responsibility over many more patients. A doctor’s competence is more complex, so he has more ways to screw up. A doctor can make more autonomous decisions, often makes them alone, and can’t as easily ask help from others. He also leads a team, so he doesn’t have to execute all his mistakes himself.
I disagree with your implication. Most doctors and nurses are responsible for specific treatment aspects of a few tens or hundreds of individuals. A small minority of doctors influence larger numbers (e.g. department heads), but even then many of their instructions are carried out by nurses and junior doctors.
Nurses who administer treatments have ways to screw up that are not available to doctors who merely select those treatments. A doctor can order a harmful procedure; a nurse can actually administer the wrong drug by mistake. A doctor can make a mistake in surgery; a nurse can make a mistake in intensive care.
I think empirical data is needed to elucidate the amount of mistakes (or “responsibility”) owned by doctors and nurses. It’s not something that can be clearly deduced from first principles.
You disagree with the implication or the claim? Do you disagree with it completely or do you think it’s exaggerated? ETA: It seems it was exaggerated, but right. There are about 3 nurses per doctor on average in OECD countries.
That’s one of the key points I made. A nurse can’t make other people carry out mistaken orders. A person carrying out a mistaken order isn’t necessarily incompetent, although in easy to spot cases they are.
Sure. A doctor has hundreds (or thousands) of diagnoses and medications to choose from. That makes me pretty confident that he has more options for fatal mistakes, and that the probability of doing the right thing is much lower.
I think the more difficult question is what constitutes incompetence, and what levels of incompetence are comparable in nurses and doctors. I strongly suspect that our main disagreement comes from this aspect.
I think I agree what Joshua said here so debating this point much further isn’t of much interest anymore.
The claim was that doctors are responsible for more patients. I’m not sure that is correct; your link about there being more nurses says,
Anyway, what I meant by the ‘implication’ (should have elaborated, sorry) was the implicit claim that because doctors have responsibility over more patients, that means they can do more damage if they screw up. But even if a single doctor does more damage than a single nurse (and I’m not sure of that), 5% of doctors screwing up would still do the same amount of damage as 5% of nurses screwing up.
A doctor knows thousand of diagnoses but for a patient complaining of knee pain most of them are completely irrelevant and would never be diagnosed by mistake.
Also, a nurse can administer any treatment a doctor can prescribe, so nurses also have theoretically thousands of medications to administer by mistake.
Finally, most nurse also has a range of mistakes, having to do with physically taking care of the patient, which aren’t available to most doctors, who don’t perform dangerous procedures every day.
Certainly true but not relevant.
Fair enough. We could continue this forever, but I wouldn’t find that especially rewarding. I quote myself:
Which requires more incompetence: making a wrong diagnosis and prescribing the wrong medication, or giving the wrong medication, when you’re given the name of the medication? I’d say the latter, and so they wouldn’t be comparable.
Peace out.