this post was submitted on 17 Feb 2025
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Headlines like this are annoying AF. You wouldn't want your doctor keeping their phone on DND 24/7.
Edit: I didn't expect people to need examples, but here you go, something that happened to me few months ago:
23:21 - my IP phone rings, I'm literally about to go to sleep but I set this specific type of call to come through. I recognize the number and I know it's an emergency so I pick it up. A patient's family calling about them being in their local ER and the ER physician is about to pull the plug on my patient. I spend the next hour yelling at the ER physician to do his fucking job, frantically arranging a transfer. Next day afternoon, I'm having a full conversation with my patient in our hospital. If I didn't fight for this person, and let this go through the regular channels, they would have died.
My comment isn't primarily about work culture or work/life balance. There are some calls that you take because it's the right thing. Advice from people who claim they can turn off all notifications just tells me two things, 1) they don't know how notification scheduling works 2) they aren't the kind of people that others ever rely on in an emergencies.
No you do not.
You don't want an incredibly tired person prescribing treatment for you or, worse, operating on you, unless you have some kind of death wish.
You want a proper call rota with the doctor "on call" and only the doctor "on call" to have their work phone ON and be available during their on-call hours.
That idea of yours would be perfectly fine if it was just you, but it isn't: it's you and all other people who think like you (or if they start by not thinking like you, they'll change their minds when they see others who do think like that get prompt service whilst they themselves do they not).
That logic just leads to people who if they make a mistake can kill you or give you a problem for life (by prescribing your the wrong medicine or, worse, cutting the wrong thing whilst operating) being very tired and hence way more likely to make mistakes.
Having a single professional having to be on call 24/7 is very much a Tragedy Of The Commons situation - fine if only one or two people used that availability only for very urgent problems, a disgrace for everybody when lots of people innevitably use that availability for any shitty shit little thing.
Definitely not an "idea of mine". That's the US experience (I'm a doctor here). The US's most common electronic medical record system developed a secure messenger app that replaced pagers so yeah for outpatient work most of the time-critical messaging goes through your cell. So no, I can't be on DND 24/7. (I do have very aggressively tweaked work/personal/etc notification settings, but sometimes the urgent messages do need to come through after hours)
How's the most expensive healthcare in the world supposed to be a convincing example?
it's neither a US- nor a profession-specific issue. it's an issue of any high-stakes, relatively niche occupation.
Not really any one, most sectors have office hours, schedules, on-call rotation etc.
It's unusual to saddle a single person with 24/7 required availability. Do you not have a single colleague you can rotate after hours calls with?
Headline reads: "i turned off ALL notifications forever".
My take: there exist people who can't do that.
Your take: US bad.
My take: not a US-specific issue.
Your take: please describe your call schedule in detail because your claim is unusual.
Thank you, but no thank you.
As a Dr’s kid nothing you have said sounds unusual for your job. My dad didnt like getting calls asking for free care but he was more than happy to run to the neighbors house when my buddy, aged 5, called at 3am and said “The baby is blue!”. That baby is 45 years old now and not blue.
Tbh suddenly changing skin color is nothing normal for humans
And it's great my buddy's first thought was that my dad lived a block away and is a doctor.
Yeah I think your inability to turn off notifications is artificial. There's no reason that these emergency calls can't go to a landline in a staffed hospital instead of directly to one specific doctor.
If the organization requires this, that's different from it actually being impossible to do otherwise.
If your hospitals are businesses, you as their employee are subsidising them. They could spend the money on an additional, qualified doctor, but they won't.
So many assumptions...
No your context is very relevant
So you aren't required to be on call, you want to be on call. You want it because your patients are not well served by general practitioners, and providing 3rd parties the whole context of care they need is difficult.
That's fine.
Well, I'm sorry for you guys to have to work under the worst of American management culture (the baseline of which, compared to Northern Europe and Scandinavia, is pretty bad).
Coming from a Southern Europe country and having worked in a couple of countries including Northern European ones, it's my experience that a lot of those abusive work practices you see in Anglo-Saxon and Southern European management cultures are neither needed nor efficient, and instead are just the product of bad organisation (read: incompetent management) and employees enduring it under the mistaken assumption that "that's just the way things are"/"there is no other option" because they've never worked in an environment with proper management.
If there is one thing that going to Northern Europe and working there taught me is that those things are almost never needed and most definitelly are not universally the way things are.
the more specialized the workforce, the harder it is to overcome staffing limitations. for example, in Italy, there's a huge physician shortage (at least when I lived in Europe there was). You won't fix that with simply changing the management culture.
From what I've observed when living in the UK and now that I'm living in Portugal, it's shit management practices all the way up, with the politicians at the top being the worst managers of the lot.
But yeah, I can empathise with being in an work place were no matter what you do to try and manage your time to deliver your best (as the years went by in my career, I've learned various professional occupations which are are part of the "feed-in" for the main work I do, to quite an advanced level, merely as a means to improve my performance at delivering the right results at the right time, which is taking efficiency improving to quiet an extreme level), it just feels that all levels all the way up are working against you and that you're just rowing against the current all the time.
Fortunatelly for me, I can just change employers and even countries if I think the overall work conditions are shit and I will never be able to properly manage my time, though I've noticed that plenty of medical professionals can't, plus in my experience, when you're snowed in by out of control inflows of work, you don't generally have the energy to even start planning your way out of it.
That said, having moved from The Netherlands (whose management and work culture is generally very good) and into Finance in the UK (which is a pretty hectic and ill organised "shoot from the hip" environment), it's perfectly possible to apply the techniques of highly organised and well managed environments in disorganised ones to produce superior results (in speed, quality and predictability of delivery timings) to those of everybody else there.
That said, I'm talking about Software Engineering here, which is a Logic+Creative area were you can "backup your patient" before you do something in case you make a mistake, unlike Medicine (though in Finance things can get "interesting" - read millions of dollars can be lost - if your code starts getting used by Traders and it's not working properly). On the other hand one would expect that in Medicine, being properly rested in order to reduce the risk of mistakes is even more important.
Your doctor has a work phone that is available only during hours.
if they are doing outpatient work, they don't. even worse, the paging systems migrated to cell phones.
sauce: am doctor
You really should use a separate phone though. Even if it's just a virtual phone. Everyone deserves to have free time.
I use an IP phone for calls that you can switch off. The paging system is a whole 'nother story.