How resident work-hour restrictions is affecting housestaff:

The conversation is shifting. Traditional hierarchical patient management is giving way to the need for “scut management” as work hours, thrown in amongst teaching sessions, draw short. Divide-and-conquer. No time for supervision. Hurry up! We’ve got to get done!

These restrictions have to be accompanied by a sizable bump in ancillary staff to reduce scut. Filling out paperwork and drawing blood for instance. Housestaff should not be glorified secretaries or phlebotomists, and instead focus on managing the patient.

This probably isn’t happening, especially in financially-strapped inner city hospitals. What will happen is that medical students will start applying to wealthier hospitals that have appropriate ancillary support.

Less scutwork will maximize learning. Every minute counts when the you’re on the clock.