Friday, September 5, 2014

US adds 142,000 jobs in August; 'Income inequality is as bad as you thought'; Why would doctors commit suicide?


1 US adds 142,000 jobs in August (Andrew Walker on BBC) The US economy added 142,000 jobs in August, latest figures from the Bureau of Labor Statistics reveal, missing expectations. The unemployment rate dipped to 6.1% from 6.2% in July. The world's largest economy had been averaging a monthly jobs gain of 212,000 in the previous 12 months.

Part of the sluggish jobs growth was attributed to a loss of 17,000 food and beverage jobs as a result of a supermarket store strike. Thousands of employees of the Market Basket chain of supermarkets in the northeastern US had gone on strike in July to protest the firing of their boss. The dispute was resolved late last week.

There were some bright spots in the August jobs report: wage growth, a crucial sign of the strength of the US economy, ticked up slightly. "Disappointing" was how the jobs figure was described by a number of analysts. Employment growth was sharply below the previous six months. It was not much better than what's needed to keep up with the growth in the working age population.

There are other features of the US labour market that suggest it is still weaker than what's implied by the moderately low headline unemployment rate. The numbers of people who want to work longer hours or have been unemployed for more than six months are unusually high. The new figures will reinforce the reluctance of the Federal Reserve chief Janet Yellen to move soon to raise official interest rates from the current very low level of close to zero.


2 ‘Income inequality is as bad as you thought’ (Andrew S Ross in San Francisco Chronicle) It doesn’t get much more official than this. The Federal Reserve says that the rich have gotten richer from the economic recovery while the majority of Americans have been left behind ”consistent with increasing income concentration during this period.” And those at the bottom of the heap are being pushed down further than ever.

“Consistent with income trends and differential holdings of housing and corporate equities, families at the bottom of the income distribution saw continued substantial declines in real net worth between 2010 and 2013,” the Fed finds in a report. For those older and poorer Americans it probably won’t get much better, the Fed piles on. ”Retirement plan participation in 2013 continued on the downward trajectory observed between the 2007 and 2010 surveys for families in the bottom half of the income distribution.”

The quantitative easing and rock bottom interest rates the Fed has been using to boost the economy don’t seem to have eased the lot of the majority of Americans. And while the Fed report is not news, it bears repeating, as does Fed Chairwoman Janet Yellen’s observation during her confirmation hearing last year that increasing inequality is ”a very deep problem.” Unfortunately, she said, “many of the underlying factors are things that are outside of the Federal Reserve’s ability to address.”


3 Why would doctors commit suicide? (Pranay Sinha in The New York Times) The statistics on physician suicide are frightening: Physicians are more than twice as likely to kill themselves as non-physicians (and female physicians three times more likely than their male counterparts). Some 400 doctors commit suicide every year. Young physicians at the beginning of their training are particularly vulnerable: In a recent study, 9.4 percent of fourth-year medical students and interns — as first-year residents are called — reported having suicidal thoughts in the previous two weeks.

Hospitals and residency programs recognize the toll residency takes on the mental stability and physical health of new doctors. In 2003, work hours were capped at 80 hours a week for all residency training programs. But despite such efforts, people still fall through the cracks. While acute stress, social isolation, pre-existing mental illness and substance abuse may be obvious factors to consider, we must also ask if there are aspects of medical culture that might push troubled residents beyond their reserves of emotional resilience.

There is a strange machismo that pervades medicine. Doctors, especially fledgling doctors like me, feel pressure to project intellectual, emotional and physical prowess beyond what we truly possess. We masquerade as strong and untroubled professionals even in our darkest and most self-doubting moments. How, then, are we supposed to identify colleagues in trouble — or admit that we may need help ourselves?

In fact, very little about us changes, apart from our legal ability to prescribe medications. But meanwhile, our workload increases along with the expectations and demands we place on ourselves. Within a month of graduation we are required to have a comprehensive understanding of up to 10 patients on any given day. This drastic increase in responsibility can and does overwhelm most interns.

Some stoics may invoke the creed of Sir William Osler, who founded the first American residency program at Johns Hopkins Hospital in 1889, to argue that physicians must push aside our personal burdens to care for the sick. But a tired and depressed doctor who is an island of self-doubt simply isn’t as likely to improve the outcomes of his or her patients — or ever truly care for them.

No comments:

Post a Comment