Netflix should so a show on the far superior Canadian system of socialized medicine. Plot lines about people dying on years-long waiting lists for routine procedures. Or about the fact that the entire country has fewer MRI machines than does Atlanta (despite spending more per capita on healthcare than almost any country on earth besides America). The season finale could be the depressed teenager who is offered MAiD and successfully euthanized as her anguished parents are held by security guards outside the hospital.
The Pitt seems pretty histrionic and detached from reality. "Healthcare is too expensive, but medical staff are vastly underpaid" (despite being paid more than anywhere else in the world... the average registered nurse in NYC makes $112k a year). How does one square that circle? Well, you can't because it is all polemical nonsense and lies.
Have you ever lived in NYC on 112K a year and felt like you were livin' high on the hog? Good luck. And what makes healthcare so expensive isn't medical staff salaries, it's all the middle men, and INSURANCE. What a bunch of bullshit that is. Not sure if you are in the US or elsewhere, but no one, not a single person in this entire country can tell you exactly what anything ACTUALLY costs. And that is on purpose. It's the place where the system works exactly as planned: farm our bodies for the crop of money you can make by selling our pain and agony back to us at a mystery price. We are the widgets that are planted, harvested, and feasted upon.
This is a great example of the histrionics I mentioned above. Also factually inaccurate. Higher treatment costs are the number one factor in excess healthcare costs in the U.S. Admin costs are a secondary consideration. Also, love the sop to pity the poor low six figure earner. I do not.
2k is extremely affordable on $112k/yr., that would put your rent just north of 20% of income which is reasonable for housing costs. NYC is expensive but $112k/yr is still comfortable there unless you insist on living in lower Manhattan...
ER doctors in PA average $400K year :) And the hospitals are raking it in—- even more than pharm and insurance companies. I agree with you, but just adding that The Pitt’s politics are woke bullshit— more Hollywood shoving their simplistic manichean ideology down everyone’s throats.
All modern progressive media is a medium to lecture and strawman their political opponents. Every time Progressives have inserted politics into tv/movies in the last decade they do so without even a hint of subtly or nuance. As somone who has grown up with it my entire adult life im sick of their self inserts, their constant moral posturing, and most of all their lacking self awareness.
At the risk of being self involved and overly dramatic, I read this as a commentary on my life in Higher Education. I suppose this is the point; medical dramas are just heightened, neon-lit pictures of The Way We Live Now. Better this than The White Lotus, I suppose. I watched a season and a half of the latter and could never get past a sense of “but who _are_ these people”. With things like The Pitt, I know: people like me.
God yes re The White Lotus -- I found it totally impenetrable (and really annoying). Everyone is so *awful*. Lol at self-involved and over-dramatic - I think that's just the price of entry around these parts ;-)
I had the same reaction to White Lotus. But a million years ago I also wondered the same about Sex in the City. I lived in NYC at the time and knew absolutely zero people who were like those women. Where are these plot lines and characters coming from?
The White Lotus was literally described to me as a show if you like watching shitty rich people die. Pretty accurate. Not a show asking for a ton of sympathy for its characters. It knows what they are.
White Lotus isn’t that bad. It’s genuinely good character drama, but I get what you’re saying. I’ve been watching older stuff on Pluto and Tubi and the difference is night and day.
Haha. That's pretty accurate, indeed. It has me reflecting on a trend I have noticed on all the many streaming options we now have. I only watch a handful, but I have tried at least a dozen different ones to see which ones have the most interesting programming, and then I find a few shows I like and watch them through.
Well, it's hard to find a series on any streaming platform anymore that doesn't involve some interminably long episodes that are nothing but literal torture. Dark Winds on AMC + just did that with some Nazi German woman who tortured the protagonist with poison gas and bondage. I was so bored. I just skipped ahead about 25 minutes to nearly the end for the plot resolution.
Vlad on Netflix, starring Rachel Weisz, who also produced it. WTF was that about? Some disturbed wifey who doesn't want to admit her wifey-ness has an unending fantasy about a younger man and then when she finally gets him in her bed by seriously drugging him, she then chains him to a chair.
Absolutely anything produced by Taylor Sheridan on any number of streaming services will involve gratuitous pain infliction, and so on.
The question is, why all this brutality? The only answer I can think of is that we've lost the center and so are untethered to any sense of proper limits, to proportion, or to symbiosis, so we have no clue when to stop. Like Trump.
Every generation thinks the one before it is responsible for the chaos and ineffectiveness of the world they inherit, LOL. It's tedious and incredibly whiny but the best part comes 30 years later when it's their turn, they find out the job isn't quite as easy as they imagined when they were twenty one and full of self righteous indignation, and the next generation is all huffy and pissy and blaming them because the world is still a mess. Hahahaha.
In broad strokes, yes, I agree. But there is nothing similar to Gen X at our core compared to Boomers. We, as a generation, are not selfish. We are the ones who just get shit done. Frankly, I think there are more similarities between Millennials and Boomers, and that is why they are less inclined to like one another.
This made me sad. Is it because I’m an American Gen Xer?
Firstly, for Gen X to be held with contempt for breaking a system, any system, is rich. We are the generation stuck taking care of ourselves because our parents were the first free love/ lots of divorce generation. And we are the first generation to have to also take care of those aging narcissists while still dealing with our own lives and our children, who, meanwhile, the Gen Z crowd, are depressed over the mess the world’s in thanks to Boomer psychopaths like T and the monster class he surrounds himself with (which are mostly Boomers and Millennials so fuck off, haters). What I’m saying is, we didn’t as a generation do anything except pick up the pieces for everybody else.
And because I love the UK but am so tired of being told that as an American I must always be accompanied by an adult, I have just two words: Boris Johnson.
Also, my other uncle (you know who the first is) cast ER. 🇺🇸
OH and I meant to say - what an extraordinary job your uncle did on casting ER! We’ve been on a S1/2 rewatch and the casting is jaw-dropping in retrospect.
We used to get on his nerves saying George Clooney wasn't that talented, hahahaha. And yet I watched Jay Kelly twice in the same week, I thought Clooney was perfect being an actor playing himself. My brother shows up in ER once or twice as a cop or an ambulance driver. Uncle John also cast West Wing, so my brother (also a casting director) shows up in WW, too. A cop mostly.
Having walked the pup and cooled off, it occurred to me to caveat my rant by saying it’s not at anyone in particular other than generally. In America, I know there is more solidarity with those critical of us, than not. We don’t like him either.
deserved or not, the boomer hate I've been seeing lately borders on pathological.
everyone knows Gen-Xers are STILL waiting for their turn to run the world because boomers will not relinquish power or retire or go away or even die (they'll probably outlive both Gen Xers and Millennials since wealth helps people live a lot longer).
Re: Gen X being who broke the system, I was referring to Rowan's having said that the younger doctors in The Pitt are upset with the Noah Wylie character because he is part of the broken system. I don't know if others blame Gen X for anything. You're probably right that it's not a trend. More like it is that we don't get our due for how much we hold the other generations together, at least the one before and one or two after us. I don't have a Millennial child, but I do have Gen Z.
It's true what you say re health and wealth. Money is the best risk prevention.
Yeah, I think what I noticed about The Pitt is that it addresses Gen X in a way few other shows do. Not explicitly -- nobody ever talks about Gen X -- but because Wyle and Katherine LaNasa are that (our) age, that's the implication. And also -- although I hope you know this anyway -- I definitely don't feel contempt for Americans! That's why I was really surprised to see what I was seeing on Bluesky.
Thank you for this great perspective. I'm an emergency physician in the US. I've been at it for 36 years if you count my residency training. When 'ER' was on, and I was working nights early in my career, my wife made me stop watching because I just yelled at the screen: 'that's not what we do!' I don't watch The Pitt. I generally don't watch any medical dramas. (I did love Scrubs, but it's a comedy.) I know that The Pitt has great technical consultants. What they may lack is 'social consultants.' Outside of large urban teaching centers, particularly in suburban and rural America, physicians and nurses tend to be more centrist and often lean solidly to the right. It's not uncommon for emergency physicians outside of large urban centers to spend down-time talking fondly about Trump, discussing their latest AR-15 build or hunting trip, and showing pictures of their spouses and children. The thing is, outside of those hospitals, they're mostly quiet about their beliefs having learned even before Covid that 'wrong-think' could have professional consequences. I have written columns about emergency medicine for decades, and they often had a funny but sometimes conservative and Christian leaning angle. Many times, at conferences, physicians would come to me, look over their shoulders and quietly say 'I'm glad you wrote that; I want to say it but can't.' It's ironic that the characters on the show feel so overwhelmed and unheard. People like them have driven the narrative in medicine, out of the safety of academia, for decades. When the US passed EMTALA, the 'anti-dumping law' that was meant to create a medical safety net in our ERs, lives were certainly saved. But ultimately, the hospital ER became more and more overwhelmed by free care, and became the epicenter of social crises. That's a prescription for frustration, especially when the left-leaning narrative allows no room for personal accountability in our patients. And physicians, young and old, are burning out faster. Younger docs are often desperate to find a way out of the ER. Personally, I find it difficult but rewarding. Every day is a puzzle, but a gift. But then, I like my patients, I like my co-workers and we have a lot in common. And while there are things we could do better, we do our best and go home knowing that.
“That's a prescription for frustration, especially when the left-leaning narrative allows no room for personal accountability in our patients.”
Oooh. That comment cut through. I would argue that the dominant narrative for too long has been that a sick person’s personal responsibility is the factor overriding anything else. You haven’t watched The Pitt…it’s extremely refreshing to see attention explicitly paid to the role that systemic factors play in an individual person’s presentation in an ED.
Take the story of a recent immigrant, an overweight, insulin-dependant diabetic without health insurance. He titrates his insulin dose down bc he can’t afford the costs and presents in DKA. He is resuscitated, needs ICU monitoring but the costs would break him. He and his wife work multiple jobs which earn them just too much money to get Medicaid/Medicare. The hospital cuts a deal to allow him to stay in an unmonitored bed for a big discount. But he ends up absconding because the medical debt he already has is going to ruin his family.
Would a centrist or right leaning narrative prefer to couch that story in terms of his personal responsibility? Cast him as greedy because he’s fat, stupid because he’s poor but hardworking, uneducated because he didn’t think cutting down his insulin would threaten his life?
Yep. I'm still trying to absorb what The Pitt says about institutions. It seems to say that institutions, including hospitals, are set up to be extractive, so that those who wish to merely work in them are systematically excluded, and only those with messiah complexes or life-consuming passions for their job can survive.
I fell out of corporate & institutional life some time ago, so I guess it doesn't affect me. But it sounds horrible.
Yeah, that's interesting. I suppose the wrinkle with public services is that they *can't* be purely extractive (that's literally not their purpose), so when the emphasis moves towards that it introduces all kinds of head-exploding outcomes. In a way it's easier to just work for a massive corporation that's explicitly focused on providing 'value for shareholders' - at least nobody's lying about what they're doing.
That is true. Although less and less is it corporate America but Private Equity US. And it's not the doctors' fault, largely. If any physicians are obnoxious, it's certain specialties, but not doctors en masse.
Just to say, I really want to read this piece but I love The Pitt so I don’t want to subject myself to spoilers. Do I have to wait for the end of the series before I come back to it?
Health care is plagued by unrealistic expectations and perverse incentives. Much like the old sign hanging in many a car repair garage (“Repairs done right, fast, cheap — pick two”), when it comes to health care everyone wants quality care, affordable care, and universal care. There’s just one catch, you only get to pick two outa three.
Today’s health care consists of too few trying to provide too much to too many … and the system is irretrievably broken.
I haven't seen this show - but your description makes me wish to steer the conversation back to reality. The American-born doctors, even Gen X, are closing their practices earlier than did their predecessors, or switching to "concierge". There may be an element of "I never meant to work this hard forever and with my portfolio up, there's no need to". But in re the "concierge" business - it's as if the doctors are electing to get out of the cultural dysfunction as it manifests in the medical system (and billing) - not soldier heroically through it.
Hopefully the inner-city ERs will continue to attract adrenaline junkies.
This is never framed in progressive terms, or failure-of-progressivism terms, but a similar thing plays out on Reddit in any forum where schoolteaching comes up. Since you use the term "liberal" freely, I feel able to: the good liberal (American) public schoolteacher, esp. the lady teacher which is most of them - has had it up to here with life in the classroom and thinks any other job would be better. They may be more or less honest about why they are quitting. Watch what people do, not what they do on TV.
Yes, the system is soul crushing for physicians. I have written about it extensively in my career, the moral injury that happens to doctors who have to put corporate policy over medicine. So, as you point out, they leave.
This is a better analysis than my own on substack. I’m currently redoing all 15 series of ER. I’m on series 8 but the show tires after season 5. Maybe it’ll get better.
The intergenerational contempt that you talk about here is a feature of much of my writing. Even my daughter is contemptuous of me and my generation. It’s brutal and hurtful. When I was young I had if not respect but a feeling of kindness towards the old. This has disappeared, replaced by seething envy.
The world is fucked up. Why didn’t you fix this? I mean Donald Trump is president, no taxes or boundaries on social media or online techno giants, no way to own a home, cost of education is spiralling. We the young generation feel resentful because we don’t understand why we can’t get the same great deal you guys got in the 60s.
Netflix should so a show on the far superior Canadian system of socialized medicine. Plot lines about people dying on years-long waiting lists for routine procedures. Or about the fact that the entire country has fewer MRI machines than does Atlanta (despite spending more per capita on healthcare than almost any country on earth besides America). The season finale could be the depressed teenager who is offered MAiD and successfully euthanized as her anguished parents are held by security guards outside the hospital.
That would be complete fiction. At least “The Pitt” has grains of truth.
Well Played.
Show me on the doll where the bad man touched you…. You fucking weird angry asshole.
The Pitt seems pretty histrionic and detached from reality. "Healthcare is too expensive, but medical staff are vastly underpaid" (despite being paid more than anywhere else in the world... the average registered nurse in NYC makes $112k a year). How does one square that circle? Well, you can't because it is all polemical nonsense and lies.
Have you ever lived in NYC on 112K a year and felt like you were livin' high on the hog? Good luck. And what makes healthcare so expensive isn't medical staff salaries, it's all the middle men, and INSURANCE. What a bunch of bullshit that is. Not sure if you are in the US or elsewhere, but no one, not a single person in this entire country can tell you exactly what anything ACTUALLY costs. And that is on purpose. It's the place where the system works exactly as planned: farm our bodies for the crop of money you can make by selling our pain and agony back to us at a mystery price. We are the widgets that are planted, harvested, and feasted upon.
This is a great example of the histrionics I mentioned above. Also factually inaccurate. Higher treatment costs are the number one factor in excess healthcare costs in the U.S. Admin costs are a secondary consideration. Also, love the sop to pity the poor low six figure earner. I do not.
Excess comes from not having any idea where the boundaries are. Seriously, 112K in NYC where rents are 2K and up is not "making it".
2k is extremely affordable on $112k/yr., that would put your rent just north of 20% of income which is reasonable for housing costs. NYC is expensive but $112k/yr is still comfortable there unless you insist on living in lower Manhattan...
Spot on. Thank you.
ER doctors in PA average $400K year :) And the hospitals are raking it in—- even more than pharm and insurance companies. I agree with you, but just adding that The Pitt’s politics are woke bullshit— more Hollywood shoving their simplistic manichean ideology down everyone’s throats.
All modern progressive media is a medium to lecture and strawman their political opponents. Every time Progressives have inserted politics into tv/movies in the last decade they do so without even a hint of subtly or nuance. As somone who has grown up with it my entire adult life im sick of their self inserts, their constant moral posturing, and most of all their lacking self awareness.
It feels insulting. The moralizing is so heavy-handed.
Yes.
All media lectures. If you don’t want to watch anything with ideals or a point of view, reality tv is ok
At the risk of being self involved and overly dramatic, I read this as a commentary on my life in Higher Education. I suppose this is the point; medical dramas are just heightened, neon-lit pictures of The Way We Live Now. Better this than The White Lotus, I suppose. I watched a season and a half of the latter and could never get past a sense of “but who _are_ these people”. With things like The Pitt, I know: people like me.
God yes re The White Lotus -- I found it totally impenetrable (and really annoying). Everyone is so *awful*. Lol at self-involved and over-dramatic - I think that's just the price of entry around these parts ;-)
I had the same reaction to White Lotus. But a million years ago I also wondered the same about Sex in the City. I lived in NYC at the time and knew absolutely zero people who were like those women. Where are these plot lines and characters coming from?
The White Lotus was literally described to me as a show if you like watching shitty rich people die. Pretty accurate. Not a show asking for a ton of sympathy for its characters. It knows what they are.
White Lotus isn’t that bad. It’s genuinely good character drama, but I get what you’re saying. I’ve been watching older stuff on Pluto and Tubi and the difference is night and day.
Any recommendations?
Haha. That's pretty accurate, indeed. It has me reflecting on a trend I have noticed on all the many streaming options we now have. I only watch a handful, but I have tried at least a dozen different ones to see which ones have the most interesting programming, and then I find a few shows I like and watch them through.
Well, it's hard to find a series on any streaming platform anymore that doesn't involve some interminably long episodes that are nothing but literal torture. Dark Winds on AMC + just did that with some Nazi German woman who tortured the protagonist with poison gas and bondage. I was so bored. I just skipped ahead about 25 minutes to nearly the end for the plot resolution.
Vlad on Netflix, starring Rachel Weisz, who also produced it. WTF was that about? Some disturbed wifey who doesn't want to admit her wifey-ness has an unending fantasy about a younger man and then when she finally gets him in her bed by seriously drugging him, she then chains him to a chair.
Absolutely anything produced by Taylor Sheridan on any number of streaming services will involve gratuitous pain infliction, and so on.
The question is, why all this brutality? The only answer I can think of is that we've lost the center and so are untethered to any sense of proper limits, to proportion, or to symbiosis, so we have no clue when to stop. Like Trump.
I’m watching 90s sci-fi these days. But I do like the Pitt and yellowjackets.
Every generation thinks the one before it is responsible for the chaos and ineffectiveness of the world they inherit, LOL. It's tedious and incredibly whiny but the best part comes 30 years later when it's their turn, they find out the job isn't quite as easy as they imagined when they were twenty one and full of self righteous indignation, and the next generation is all huffy and pissy and blaming them because the world is still a mess. Hahahaha.
your point might be taken more generously if you didn't sign off cackling wickedly.
Don't care. Not my problem.
yep, you've made it clear that you don't care. 😆
can't tell if you're a troll attempting to embody every obnoxious boomer trait in one account or a real person but, either way, I wish you well
Boomer, definitely.
It's social media. Have no idea why anyone cares.
yep, you care SO little you even restacked your own comment 😆
That's funny.
In broad strokes, yes, I agree. But there is nothing similar to Gen X at our core compared to Boomers. We, as a generation, are not selfish. We are the ones who just get shit done. Frankly, I think there are more similarities between Millennials and Boomers, and that is why they are less inclined to like one another.
This made me sad. Is it because I’m an American Gen Xer?
Firstly, for Gen X to be held with contempt for breaking a system, any system, is rich. We are the generation stuck taking care of ourselves because our parents were the first free love/ lots of divorce generation. And we are the first generation to have to also take care of those aging narcissists while still dealing with our own lives and our children, who, meanwhile, the Gen Z crowd, are depressed over the mess the world’s in thanks to Boomer psychopaths like T and the monster class he surrounds himself with (which are mostly Boomers and Millennials so fuck off, haters). What I’m saying is, we didn’t as a generation do anything except pick up the pieces for everybody else.
And because I love the UK but am so tired of being told that as an American I must always be accompanied by an adult, I have just two words: Boris Johnson.
Also, my other uncle (you know who the first is) cast ER. 🇺🇸
OH and I meant to say - what an extraordinary job your uncle did on casting ER! We’ve been on a S1/2 rewatch and the casting is jaw-dropping in retrospect.
We used to get on his nerves saying George Clooney wasn't that talented, hahahaha. And yet I watched Jay Kelly twice in the same week, I thought Clooney was perfect being an actor playing himself. My brother shows up in ER once or twice as a cop or an ambulance driver. Uncle John also cast West Wing, so my brother (also a casting director) shows up in WW, too. A cop mostly.
Having walked the pup and cooled off, it occurred to me to caveat my rant by saying it’s not at anyone in particular other than generally. In America, I know there is more solidarity with those critical of us, than not. We don’t like him either.
nobody blames Gen-X for the state of the world.
deserved or not, the boomer hate I've been seeing lately borders on pathological.
everyone knows Gen-Xers are STILL waiting for their turn to run the world because boomers will not relinquish power or retire or go away or even die (they'll probably outlive both Gen Xers and Millennials since wealth helps people live a lot longer).
Re: Gen X being who broke the system, I was referring to Rowan's having said that the younger doctors in The Pitt are upset with the Noah Wylie character because he is part of the broken system. I don't know if others blame Gen X for anything. You're probably right that it's not a trend. More like it is that we don't get our due for how much we hold the other generations together, at least the one before and one or two after us. I don't have a Millennial child, but I do have Gen Z.
It's true what you say re health and wealth. Money is the best risk prevention.
Yeah, I think what I noticed about The Pitt is that it addresses Gen X in a way few other shows do. Not explicitly -- nobody ever talks about Gen X -- but because Wyle and Katherine LaNasa are that (our) age, that's the implication. And also -- although I hope you know this anyway -- I definitely don't feel contempt for Americans! That's why I was really surprised to see what I was seeing on Bluesky.
I know you don’t. But you definitely well described the tropes about contemporary views.
Agree we blame the boomers.
Thank you for this great perspective. I'm an emergency physician in the US. I've been at it for 36 years if you count my residency training. When 'ER' was on, and I was working nights early in my career, my wife made me stop watching because I just yelled at the screen: 'that's not what we do!' I don't watch The Pitt. I generally don't watch any medical dramas. (I did love Scrubs, but it's a comedy.) I know that The Pitt has great technical consultants. What they may lack is 'social consultants.' Outside of large urban teaching centers, particularly in suburban and rural America, physicians and nurses tend to be more centrist and often lean solidly to the right. It's not uncommon for emergency physicians outside of large urban centers to spend down-time talking fondly about Trump, discussing their latest AR-15 build or hunting trip, and showing pictures of their spouses and children. The thing is, outside of those hospitals, they're mostly quiet about their beliefs having learned even before Covid that 'wrong-think' could have professional consequences. I have written columns about emergency medicine for decades, and they often had a funny but sometimes conservative and Christian leaning angle. Many times, at conferences, physicians would come to me, look over their shoulders and quietly say 'I'm glad you wrote that; I want to say it but can't.' It's ironic that the characters on the show feel so overwhelmed and unheard. People like them have driven the narrative in medicine, out of the safety of academia, for decades. When the US passed EMTALA, the 'anti-dumping law' that was meant to create a medical safety net in our ERs, lives were certainly saved. But ultimately, the hospital ER became more and more overwhelmed by free care, and became the epicenter of social crises. That's a prescription for frustration, especially when the left-leaning narrative allows no room for personal accountability in our patients. And physicians, young and old, are burning out faster. Younger docs are often desperate to find a way out of the ER. Personally, I find it difficult but rewarding. Every day is a puzzle, but a gift. But then, I like my patients, I like my co-workers and we have a lot in common. And while there are things we could do better, we do our best and go home knowing that.
“That's a prescription for frustration, especially when the left-leaning narrative allows no room for personal accountability in our patients.”
Oooh. That comment cut through. I would argue that the dominant narrative for too long has been that a sick person’s personal responsibility is the factor overriding anything else. You haven’t watched The Pitt…it’s extremely refreshing to see attention explicitly paid to the role that systemic factors play in an individual person’s presentation in an ED.
Take the story of a recent immigrant, an overweight, insulin-dependant diabetic without health insurance. He titrates his insulin dose down bc he can’t afford the costs and presents in DKA. He is resuscitated, needs ICU monitoring but the costs would break him. He and his wife work multiple jobs which earn them just too much money to get Medicaid/Medicare. The hospital cuts a deal to allow him to stay in an unmonitored bed for a big discount. But he ends up absconding because the medical debt he already has is going to ruin his family.
Would a centrist or right leaning narrative prefer to couch that story in terms of his personal responsibility? Cast him as greedy because he’s fat, stupid because he’s poor but hardworking, uneducated because he didn’t think cutting down his insulin would threaten his life?
We see this a lot
Well said Edwin. Yours were some of the most balanced articles in KevinMD.
Thank you! That’s very kind of you. I always enjoyed writing for Kevin’s page.
Yep. I'm still trying to absorb what The Pitt says about institutions. It seems to say that institutions, including hospitals, are set up to be extractive, so that those who wish to merely work in them are systematically excluded, and only those with messiah complexes or life-consuming passions for their job can survive.
I fell out of corporate & institutional life some time ago, so I guess it doesn't affect me. But it sounds horrible.
Yeah, that's interesting. I suppose the wrinkle with public services is that they *can't* be purely extractive (that's literally not their purpose), so when the emphasis moves towards that it introduces all kinds of head-exploding outcomes. In a way it's easier to just work for a massive corporation that's explicitly focused on providing 'value for shareholders' - at least nobody's lying about what they're doing.
That sounds like an appalling show. I'd rather bang myself on the toe with a hammer than repeatedly subject myself to viewing such misery.
Doing everything “right” and still feeling like everything’s broken around you is a brutal place to be.
There’s a joke among young people that American soldiers will bomb your cities, then make movies about how sad it made them feel.
Why there is no equivalent about doctors and their billing departments, I don’t know
Doctors don’t have billing departments anymore. We all work for corporations who take care of all the finances…
That is true. Although less and less is it corporate America but Private Equity US. And it's not the doctors' fault, largely. If any physicians are obnoxious, it's certain specialties, but not doctors en masse.
see below
Just to say, I really want to read this piece but I love The Pitt so I don’t want to subject myself to spoilers. Do I have to wait for the end of the series before I come back to it?
Yes please wait! (And please come back when you've finished S2)
Health care is plagued by unrealistic expectations and perverse incentives. Much like the old sign hanging in many a car repair garage (“Repairs done right, fast, cheap — pick two”), when it comes to health care everyone wants quality care, affordable care, and universal care. There’s just one catch, you only get to pick two outa three.
Today’s health care consists of too few trying to provide too much to too many … and the system is irretrievably broken.
Yep. You can have any combination of two, but as soon as you try to add the third one, the wheels always come off and the whole thing breaks.
Turned it off after watching a few episodes; so much potential but came across as nihilistic lecturing.
For real.
I haven't seen this show - but your description makes me wish to steer the conversation back to reality. The American-born doctors, even Gen X, are closing their practices earlier than did their predecessors, or switching to "concierge". There may be an element of "I never meant to work this hard forever and with my portfolio up, there's no need to". But in re the "concierge" business - it's as if the doctors are electing to get out of the cultural dysfunction as it manifests in the medical system (and billing) - not soldier heroically through it.
Hopefully the inner-city ERs will continue to attract adrenaline junkies.
This is never framed in progressive terms, or failure-of-progressivism terms, but a similar thing plays out on Reddit in any forum where schoolteaching comes up. Since you use the term "liberal" freely, I feel able to: the good liberal (American) public schoolteacher, esp. the lady teacher which is most of them - has had it up to here with life in the classroom and thinks any other job would be better. They may be more or less honest about why they are quitting. Watch what people do, not what they do on TV.
Yes, the system is soul crushing for physicians. I have written about it extensively in my career, the moral injury that happens to doctors who have to put corporate policy over medicine. So, as you point out, they leave.
I guess that show would be called "The Consh" and it would be pretty boring.
This is a better analysis than my own on substack. I’m currently redoing all 15 series of ER. I’m on series 8 but the show tires after season 5. Maybe it’ll get better.
The intergenerational contempt that you talk about here is a feature of much of my writing. Even my daughter is contemptuous of me and my generation. It’s brutal and hurtful. When I was young I had if not respect but a feeling of kindness towards the old. This has disappeared, replaced by seething envy.
The world is fucked up. Why didn’t you fix this? I mean Donald Trump is president, no taxes or boundaries on social media or online techno giants, no way to own a home, cost of education is spiralling. We the young generation feel resentful because we don’t understand why we can’t get the same great deal you guys got in the 60s.