Comments on: Patient handoffs limit residents work hour cap gains

By: Jimmyz

Jimmyz — Sat, 13 Mar 2010 04:49:43 +0000

I fail to see your logic…..so you think a supertanker can drop an anchor in the middle of the Pacific if it violates mandated rest periods? No, they implemented those laws because sailors, pilots and truckers made more money by working OT or driving more miles. If you were so tired last night at 9pm, then why don’t you hire extra OBGYN’s to cover for you…..wait, it probably means that you will make less money.

By: docguy

docguy — Fri, 12 Mar 2010 15:05:38 +0000

the problem is that truck drivers stop driving, pilots stop flying, but patients continue to need care. Also there needs to be some training to recognize you are going to be working tired when you get out of residency. That’s life. I’m a obgyn, I got tired last night at 9pm when my patient came in labor. I would have loved to have said I’m going home, I know you just had a seizure but the next guy is pretty good, see you in the morning hopefully.

By: jimmyz

jimmyz — Fri, 12 Mar 2010 01:37:19 +0000

Typical arrogance of modern medicine to think that there isn’t “evidence” of improved patient outcomes with better sleep. Are you F***ing serious? There needs to be a study linking physicians with lack of common sense. Every industry that has safety issues such as truckers, airline pilots, oil tankers (Oil Pollution Act 1990) have mandated sleep requirements and work hours. So what if there ain’t evidence of improved outcomes? Even an idiot knows that people perform better without sleep…they don’t need some study to prove it. Unfortunately, doctors are either driven by money (less residents = more costs to hospitals) or are pretty stupid. Probably both.

By: jsmith

jsmith — Fri, 12 Mar 2010 00:29:29 +0000

Should be extend, not extent. Workin’ too much.

By: jsmith

jsmith — Fri, 12 Mar 2010 00:28:21 +0000

Your point is well-taken. Extent the study. The problem with that, of course, is that once the shorter hours genie is out of the bottle, there might be no way to it put it back in. I for one am skeptical about bankers’ hours for residents.

By: Mary Bee

Mary Bee — Thu, 11 Mar 2010 19:26:03 +0000

The patient has to be handed off sometime during their hospital stay. So what does it matter if it’s at hour 12, 16, or 30? There will be always be discontinuity of patient care unless the resident is there 24/7 until the patient is discharged.

By: Frank Drackman

Frank Drackman — Thu, 11 Mar 2010 13:59:53 +0000

Well when I trained, in the 80′s we worked 300 hrs/week, every other night call, all for $17,000/year and 2 White Coats. And We did it all on GUTS, and INITIIATIVE!
And 10 grams of Amphetamine Sulfate/Week…
and I know, we had Mullets, wore Stone Washed Jeans, and Drove IROCs with T-Tops, so obviously our judgement was impaired, to be generous.
Problem is there’s still the same amount of work to be done, probably MORE, since even a CABG/AVR/MVR gets done as an outpatient now a days, and even “Physican Extenders(sounds like an ED tx) won’t work nights/weekends, at least not for the <$10/hr Residents make…
Frank M.D.

By: jsmith

jsmith — Wed, 10 Mar 2010 21:01:23 +0000

It seems as if a little experimentation is in order. Have System A implement shorter hours and System B not. Get the Biostat guys to figure out the sample sizes and other such details. See which system gives better results here in the USA, with our system of postgrad medical education. (Europe doesn’t count because of potential extrapolation error. ) Do it over a year, and randomize after the match so as not to get intern choice of spots as a confounding variable.

By: BladeDoc

BladeDoc — Wed, 10 Mar 2010 16:43:18 +0000

jsmith,

I like it. Now what do you do if the residents in the shorter work week turn out to be incompetent at the end of their residency?