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No Doctor Should Work 30 Hours Straight with No Sleep

theatlantic.com

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Re: No Doctor Should Work 30 Hours Straight with No Sleep

#101

Post by tspike »

rileyteige wrote: post #81
edblarney wrote: post #13

You 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.

I'll mention the same thing here that I just did elsewhere in the thread to someone else: While I agree with you, I have to words: Doctor shortage. At least in the US, we need more doctors. Many of the doctors with whom my wife works all see dozens of patients every day, leaving them with mere minutes for each of them as it is. A 2-minute turnaround is very common, especially in the internal medicine / family medicin…

I wonder if part of the reason we have a doctor shortage is because people see the inhumane working conditions and decide not to pursue it as a career.

Re: No Doctor Should Work 30 Hours Straight with No Sleep

#102

Post by ceejayoz »

mpcadosch wrote: post #23

Has anyone tried this service? http://circadienhealth.pagedemo.co/ It seems targeted towards nurses, but could be applicable to physicians as well.

Misspelling circadian isn't a great sign.

The ICU my wife worked in resisted carrying emergency buttons around on privacy grounds because they included location tracking. One that tracks physiological data and presumably analyzes sleep outside of work would've probably had them striking.

Re: No Doctor Should Work 30 Hours Straight with No Sleep

#103

Post by module0000 »

realitygrill wrote: post #95
module0000 wrote: post #89

Earlier quoted context omitted.

A very soldier-worthy attitude to be admired.

You don't think that's kind of questionable?

Demanding perhaps, but not questionable. It's just the nature of the industry. Not an apples-to-apples comparison, but look at combat medics for contrast during wartime. There are limits to what humans can do, but the 120-hour workweek in a heated-and-cooled hospital does not bump into those limits.

Maybe it would be 'better' if that wasn't the case, but it's simply what is.

Re: No Doctor Should Work 30 Hours Straight with No Sleep

#104

Post by uremog »

wildmusings wrote: post #98
mcv wrote: post #92

Earlier quoted context omitted.

So what happened? Was there a massive disaster that created an overwhelming flood of patients, that everybody needs to work overtime? Because under normal circumstances, a competently run hospital should be able to function with normal 8-hour shifts. If that's not possible, then management fucked up. Accepting these kind of hours as standard is completely unreasonable and dangerous, especially in hospital, where live…

The AMA enforces an arbitrary limit on the number of medical school spots and therefore doctors in the US. They create a shortage of doctors in order to keep doctors' pay high.

So they're basically DeBeers for doctors?

Re: No Doctor Should Work 30 Hours Straight with No Sleep

#105

Post by maxerickson »

rileyteige wrote: post #100
wildmusings wrote: post #98

Earlier quoted context omitted.

The AMA enforces an arbitrary limit on the number of medical school spots and therefore doctors in the US. They create a shortage of doctors in order to keep doctors' pay high.

I was unaware of the medical school cap, but there is a residency cap set by congress in 1997 that also aggravates the issue: http://www.medpagetoday.com/PublicHealthPolicy/MedicalEducat... >Medicare already funds a bulk of the residency training in this country -- to the tune of about $9.5 billion a year. But its support was capped by Congress in the Budget Control Act of 1997.

The medical system has billions of free cash flow. Big hospitals could fund lots more residency spots.

Re: No Doctor Should Work 30 Hours Straight with No Sleep

#106

Post by hahajk »

TheOneTrueKyle wrote: post #69
jseliger wrote: post #11

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…

I'm curious why so many people still put up with it?

I always wondered why the public puts up with it. Aviation is always provided as a contrast to the medical community: pilots have legally-mandated sleep requirements.

My hunch is that when a plane crashes, everyone freaks because planes aren't supposed to crash. When someone dies at a hospital nobody notices because people die at hospitals all the time.

Re: No Doctor Should Work 30 Hours Straight with No Sleep

#108

Post by cc439 »

dnautics wrote: post #4

Didn'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).

Failed handoffs are a process issue and working doctors and nurses harder is just a bandaid on a broken process. I'm viewing this from a manufacturing quality system perspective and while manufacturing a product is far different from treating a patient in a hospital, at the core they are both processes.

There are far more variables involved in successful medical care but the disparity in failure rates is just too large for me to believe that the idea of QA/QC in the healthcare system is anything more than an afterthought.

Re: No Doctor Should Work 30 Hours Straight with No Sleep

#109

Post by rileyteige »

pdxandi wrote: post #84
rileyteige wrote: post #64

Earlier quoted context omitted.

I can definitely relate with you on this story. My wife is getting ready to start an OB/GYN residency next year (lasts 4 years for those who don't know). She just wrapped up interview season and each program had just about the same scheduling for their residents: 5 12-hour shifts at a minimum if you're lucky with one 24-hour shift per week on top of that. Often times I heard "one weekend off every six weeks". Then th…

Can relate to all those points. The Match was especially brutal on us because there were only a handful of programs within 2000 miles of our home (West Coast) so we said goodbye to our lifelong friends and family and moved out East. It's a bit late for you, but I created a website ( https://medmap.io ) to help with The Match process. I have plans to improve it and make it more community driven, but it at least helps…

That is a really cool website. I have some comments, and let me preface them with the fact that my wife is going to be a DO so I'm always looking for "Where is the love for DOs?":

- I don't see a way to differentiate between DO and MD programs. Along the same lines, several of the programs she applied to (like Grandview in Dayton: http://www.ketteringhealth.org/grandviewmeded/residencies.cf...) don't appear on this map (though some do, but again no indication of DO). What is the datasource for the map? Is there any way it could be enrichened?

Re: No Doctor Should Work 30 Hours Straight with No Sleep

#110

Post by wildmusings »

maxerickson wrote: post #105
rileyteige wrote: post #100

Earlier quoted context omitted.

I was unaware of the medical school cap, but there is a residency cap set by congress in 1997 that also aggravates the issue: http://www.medpagetoday.com/PublicHealthPolicy/MedicalEducat... >Medicare already funds a bulk of the residency training in this country -- to the tune of about $9.5 billion a year. But its support was capped by Congress in the Budget Control Act of 1997.

The medical system has billions of free cash flow. Big hospitals could fund lots more residency spots.

Exactly. The "limited federal funding" canard is a brazen excuse by the AMA to deflect attention from their own role, and to lobby for more free money. No one ever argues against more free money for themselves.
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