Earlier quoted context omitted.
Nurses, quite frequently yes. Physician reimbursement can be incredibly complicated depending on type of work.
Especially in the US with the Affordable Care Act.
What did ACA change about reimbursement?
No Doctor Should Work 30 Hours Straight with No Sleep
111–120 of 208 posts
Re: No Doctor Should Work 30 Hours Straight with No Sleep
#112Has 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.
It's an intentional mispelling, that's their brand name
Re: No Doctor Should Work 30 Hours Straight with No Sleep
#113Earlier quoted context omitted.
I'm curious why so many people still put up with it?
I'm a practicing hospitalist and I love it. I spend time on the hospital floor, time in the ED, and time covering patients in the ICU. Yeah, some days suck (I occasionally have to stay from 7 AM to past midnight, though that is quite rare), but overall I can't imagine doing anything else. Also, I work 7 days in a row and then have 7 days off, which I absolutely love. I have the option of working 5-days every week and…
Even if there are people like yourself who actually want to work 17 hour days for 7 days in a row (!), shouldn't we as patients be able to have doctors who are not allowed to do that insanity? Medical error is the #3 cause of death in the US. It seems entirely irresponsible to take someone's life into your hands without proper rest.
Re: No Doctor Should Work 30 Hours Straight with No Sleep
#114In the US alone, the Association of American Medical Colleges (AAMC) estimates a shortage of 91,500 physicians by 2020 and up to 130,600 by the year 2025. https://en.wikipedia.org/wiki/Physician_supply#Global_View
Note that the AMA, run by doctors, is required by US law to give their approval before a new medical school may open, or an existing medical school can expand its program.
The doctors who would see their salaries fall if supply increased have complete control over supply.
This is complete regulatory capture, and it's terrible.
Re: No Doctor Should Work 30 Hours Straight with No Sleep
#115Earlier quoted context omitted.
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.
Wouldn't blame them!
Re: No Doctor Should Work 30 Hours Straight with No Sleep
#116Jesus. 30 hours straight.
I know I wouldn't work 30 hours straight in IT - I think everybody is bound to make expensive mistakes when they're tired. And how much more for doctors? When what's at risk isn't just money but someone else's life.
Re: No Doctor Should Work 30 Hours Straight with No Sleep
#117Earlier quoted context omitted.
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.
There's a (smallish) surplus of medical school graduates, there are as many people doing residencies as there are residency slots available.
Re: No Doctor Should Work 30 Hours Straight with No Sleep
#118Earlier quoted context omitted.
Especially in the US with the Affordable Care Act.
What did ACA change about reimbursement?
Most of the changes pertain to Medicare/Medicaid. I haven't looked into it in several years, but this covers it in a nutshell as far as Medicare is concerned: https://www.medicare.gov/hospitalcompare/linking-quality-to-...
Pay-For-Performance is the key term there. And while it is certainly the more patient-friendly approach, the problem as I recall is that a lot of patients re-admit for issues that are their own fault due to them not following through on the prescribed treatment. The care provider, however, is the one that doesn't get paid, regardless of why the patient re-admitted.
Re: No Doctor Should Work 30 Hours Straight with No Sleep
#119Earlier quoted context omitted.
Proposal: Have doctors always work in pairs like we do when pair programming. The shifts of each partner consists of 8 hours but are shifted by half a phase. This way the maximum time of sleep deprivation is 4 hours and the handoff is also a process that takes 4 hours giving maximum information transfer and always a fresh mind to catch errors.
We don't have enough doctors to do that.
By design.
Re: No Doctor Should Work 30 Hours Straight with No Sleep
#120Earlier quoted context omitted.
While I agree with you, I have two words: Doctor shortage.
If that ever becomes a direct result of regulating doctors in that way, then I don't see why we can't solve that problem the same way we solved the shortage of nurses decades ago. In this case instead of importing filipino nurses, we'll just import doctors from wherever. Who know, India or China might have a surplus of doctors too. Or maybe that's the kind of problem that telemedicine will solve.
I agree that telemedicine has the potential to be revolutionary, at the very least in the primary-care field. Not sure what it could do about in-patient care, however. The other issue that telemedicine does not solve as far as I know is there are diagnostic tools doctors use beyond sight/sound - what can be palpated, what is the smell? Perhaps that's where nurses could step up?