Kevin, M.D - Medical Weblog

Want to get out of hospital fast? Then don't go in on a Thursday

Wait, we spent money studying this? Could this have anything to do with the fact that most doctors don't work over the weekend . . .







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Comments

  1. Anonymous Anonymous  

    Bullshit. I do all of my surgeries on thursday. The patients recover in house but administratively "outpaitent" and go home on Friday, have the weekend off and family at home to take care of them over the weekend. If they go back to work themselves they have an extra two days with no pay loss. If they are admitted as inpatient over the weekend then I see them. That is crap that doctors dont work weekends. If there is a patient in the hospital or with a problem, I am working. Yes I am in solo practice, because there arent a lot of docs coming out who I care to trust to share my concerns about my patients with.
  2. The above post notes the real flaw of the study. It was presumed that admissions were randomly distributed throughout the week. As anyone who has worked in an ER knows, patients come and go acording to the various rhythms of life. Further, most admissions to a hospital are elective; both the patient and the doc get to influence which day the admission happens. It has been an understanding at my hospital that Thursday was the day for big operations (with long recovery periods). This would ensure complete staffing of all services on post-op day one, and then utilize the weekend bed space and nursing staffing vacated by short stay surgical patients.

    As for docs working weekends, I just finished my group's call schedule for '07, where out of 52 weekends my name shows up 22 times.
  3. Anonymous Anonymous  

    Just another meaningless study...
  4. Anonymous Anonymous  

    I knew that line about docs not working weekends would get me in trouble. Sorry Guys. What I meant to say is that hospitals usually run a bit different on weekends, sometimes social services can't find a place so they stay through the weekend, maybe OT/PT isn't in house to clear the pt to go home etc.

    Sorry 'bout that
  5. Anonymous Anonymous  

    I knew that line about docs not working weekends would get me in trouble. Sorry Guys. What I meant to say is that hospitals usually run a bit different on weekends, sometimes social services can't find a place so they stay through the weekend, maybe OT/PT isn't in house to clear the pt to go home etc.

    Sorry 'bout that
  6. Anonymous Anonymous  

    When does Kevin come back?
  7. Well, I don't think that this study means much for people in the US and I wouldn't worry about the money spent since it's reported in the Scotsman and reflects a healthcare system and social support system substantially different than in the US.
  8. Anonymous Anonymous  

    I still haven't figured out why the vast majority of Nursing Home patients become ill and present to the ER on Friday afternoons, and I've been doing this for over 10 years, In my current job, we call it "Nursing Home Friday". Must be the lunches.
  9. Anonymous Anonymous  

    I dont know what hospital you guys are at, but I work at one of the most prestigious academic hospitals in america and on weekends the hospital definitely operates differently.

    There are much fewer doctors available on the weekends. Try getting a radiologist available on a weekend for an MRI. If you're lucky they might have one radiologist per every 100 patients in the hospital over the weekend. The staffing ratios during weekdays are MUCH higher than on weekends.

    Its not just doctors though. Even worse than doctors is the support staff like physical therapy and social work. Social workers and nurse case managers are almost non-existent on the weekends, meaning that you cant place any of your patients into a nursing home or subacute rehab on the weekends. That means they dont go home and have to hang out ean extra couple of days until the case managers come back on Monday.

    So to sum up:

    1) There are doctors in the hosptial on weekends, but they are staffed at a level MUCH MUCH LESS than on weekdays, maybe as much as a 1:10 ratio.

    2) Support staff is almost nonexistent on weekends and its virtually impossible to send a patient home or to subacute rehab or to nursing home because you need case managers for all that stuff.
  10. Anonymous Anonymous  

    and if the support staff aren't there, then there isn't much call for the docs to do much other than make quick rounds to be certain that things are stable until Monday.
  11. Anonymous Anonymous  

    One radiologist for 100 patients. We never have that. We have one radiologist for the entire 350 bed hospital. And he's in India.
  12. Anonymous Anonymous  

    "Try getting a radiologist available on a weekend for an MRI."

    Wow! If that is our only complaint for waiting times for MRIs in this country then we are doing extremely well. In Canada it takes up to 4 months for an MRI for a brain tumor!!!

    Check www.onthefencefilms.com and the short film "A Short Course in Brain Surgery" to see the Canadian healthcare system up close and personal through the eyes of a brain cancer patient.
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