Resident work hour restrictions

Boston’s BI-Deaconess’ surgery program was cited for violations of the strict resident work hour restrictions. No doubt, this is happening in hospitals across the country:

“When your 80 hours are up on Friday and someone comes in with a ruptured aneurysm, we don’t have the luxury of saying ‘Sorry, I have to go home,’” said Dr. Scott Johnson, a transplant surgeon who has headed the hospital’s surgery training program since November. “Every hospital in the country is struggling with this issue.”

Surgical residencies are placed under more strain, since the work is more demanding, and the size of the programs are generally smaller.

One way or another, hospitals are going to pay dearly for the restrictions. The cheap labor that residents provide will be severely curtailed (moreso if the proposal for the 56-hour cap passes).

Also, hospitals will be forced to hire a cadre of mid-level providers to support the residents and get them home on time.

As an aside, I find it amusing that BI-Deaconess has banished pre-rounding:

Many residents who violated this rule were working late and then coming in as early as 4 a.m. to prepare for early-morning patient conferences, called rounds, with senior doctors.

Johnson said that Beth Israel Deaconess prohibited “pre-rounding” three years ago . . .

How can they possibly enforce this? It’s bizarrely stigmatizing dedication to patients.

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