The culture of medicine, at least at the physician level, is completely insane; it's so insane that describing its insanity is part of the reason I wrote "Why you should become a nurse or physicians assistant instead of a doctor: the underrated perils of medical school" (https://jakeseliger.com/2012/10/20/why-you-should-become-a-n...). Residents in particular have no power, and even physicians themselves frequently feel they have no choice but to match the death-march pace set by administrators or their most deranged colleagues.
No Doctor Should Work 30 Hours Straight with No Sleep
11–20 of 208 posts
Re: No Doctor Should Work 30 Hours Straight with No Sleep
#12I remember hearing about sleep deprivation in the medical field before; especially for people who work in the ER or as surgeons. The demand in the US for nurses and doctors is very high, and so are the education costs which can be prohibitive to people getting into medicine. There's a whole system of failures, from the cost of education to the student loan systems to medical insurance and billing, that has led direct…
The cost of education isn't a obstacle to people getting into medicine, except indirectly by slowing down the opening of new medical schools or expansion of existing ones--otherwise we'd be seeing lots of open spots in and reduce competition for admission to medical schools, which certainly isn't the case. Moreover, new medical schools with a total of 1000+ seats have opened in the past few years. The real bottleneck is in the number of residency slots, which hasn't changed in 20 years.
Re: No Doctor Should Work 30 Hours Straight with No Sleep
#13You wouldn't want your airline pilot to be sleep deprived so why would you want your doctor to be?
Unless you're a field medic in the army or whatever. No thanks.
Re: No Doctor Should Work 30 Hours Straight with No Sleep
#14The medical system will disagree: all doctors should work 30 hours straight with no sleep, else they're not real doctors and slacking off.
You have people that have gone through the ringer to become doctors. These are the type of people that when you say jump, they ask how high. You can pretty much get them to do anything you want... because they are self-selected to be that sort of people otherwise they could have never become doctors. So when a manager comes to them and tells them they have to work so and so hours, they do it. And they suck it up, because that's who they are.
Re: No Doctor Should Work 30 Hours Straight with No Sleep
#15I wonder why sleep monitoring is not used for pilots and doctors and other people working on mission critical jobs.
Re: No Doctor Should Work 30 Hours Straight with No Sleep
#16I wonder why sleep monitoring is not used for pilots and doctors and other people working on mission critical jobs.
Because nothing bad enough has happened yet.
Re: No Doctor Should Work 30 Hours Straight with No Sleep
#17Didn't they do a study and find that decreasing doctor hours caused an increase in patient mortality because of handoff errors? And that digitizing records didn't help because of a combination of inaccurate measurement by the staff and because of factors that can't be measured (intuitive observation, etc).
Who is this they?
Here is a bit of survey on the topic from April of 2013:
https://psnet.ahrq.gov/perspectives/perspective/140/are-resi...
Key finding: "In summary, the literature still does not definitively tell us whether limiting duty hours improves patient safety."
Re: No Doctor Should Work 30 Hours Straight with No Sleep
#18We shouldn't discount the possibility that the regimen is designed to break doctors down psychologically.
Re: No Doctor Should Work 30 Hours Straight with No Sleep
#19Didn't they do a study and find that decreasing doctor hours caused an increase in patient mortality because of handoff errors? And that digitizing records didn't help because of a combination of inaccurate measurement by the staff and because of factors that can't be measured (intuitive observation, etc).
Who is this they?
That would be Desai, et al. Though I can't access the paper right now, they say that the 2011 regulations have tripled handoffs, increasing handoff risk. It also turned out that the average amount of sleep per week was not increased by much after instituting the regulations.
[1] https://www.sciencedaily.com/releases/2013/03/130325183819.h...
[2] Desai SV, Feldman L, Brown L, et al. Effect of the 2011 vs 2003 Duty Hour Regulation–Compliant Models on Sleep Duration, Trainee Education, and Continuity of Patient Care Among Internal Medicine House Staff: A Randomized Trial. JAMA Internal Medicine, 2013; DOI: 10.1001/jamainternmed.2013.2973
Re: No Doctor Should Work 30 Hours Straight with No Sleep
#20I know what my code looks like after 30 hours of coding with no sleep (unfortunately)... it's not pretty and takes days to recover from. Thank goodness no one's health depend on my code.