The consequences of limiting resident work-hours

It seems intuitive that better rested physicians equates to better patient care.

Surgeon Pauline Chen takes a look at the repercussions of further limiting work-hours, saying “even the best attempts at cure do not come without strings attached.”

There’s something to be said for being a patient’s dedicated doctor. Back in the days without work restrictions, Dr. Chen was “able to forge the kind of strong personal and clinical connections that helped me offer them more relevant, sometimes lifesaving, clinical care. I never had to resort to the simulated patients, computer-generated cases or foam rubber suturing set-ups that educators are now using increasingly in order to round out clinical experiences.”

There was never the 78th hour pressure of picking and choosing what educational activity to skip, and after graduating, there was a level of comfort that only comes with time and clinical experience.

No data firmly exists showing that limiting resident hours actually work. In fact, “there have been few, if any, large-scale studies on how strictly residency programs have followed the 2003 mandate; which scheduling adjustments have worked, or have not; how the quality of resident education might have been affected; and, most importantly, exactly how patient safety may or may not have been compromised.”

There is clearly a detriment to tired and overworked residents. I get that. I’m just saying that the we should be careful of the solution, which may make things worse than the initial problem.


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