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Thanks to Dr. McCaskill for that informative article. Mid-1980s, I i) suggested to our exhausted, rural medical team that we get another doctor. Suddenly we were "all going to starve". I ii) suggested to the hospital board, who was asking if "we could manage" in a certain manpower crunch, that we all knew that we would have to work while tired, on occasion—sometimes very tired—but that simply "managing" could not be a way of life. (None of them did that!) That seemed like a new thought at the time. Put those two together, and it's physicians collectively who have to change first, and some of that has happened, and more needs to, and as stated, it's more than saying yes or no. The system will never change if we simply enable it.
Competing Interests: None declared.