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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

#21

Post by chewymouse »

TJSomething wrote: post #19
vorotato wrote: post #9

Earlier quoted context omitted.

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 Hou…

The article is here: http://unmhospitalist.pbworks.com/w/file/fetch/65758972/desa...

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

#22

Post by finid »

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…

But nurses are no different.

We need to start addressing the leading cause of medical accidents - physicians/nurses sleep deprivation.

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

#24

Post by adub »

vorotato wrote: post #9
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).

Who is this they?

This study [0] concluded that reduced duty hours for surgical residents actually had no significant difference in patient outcomes.

[0] http://www.nejm.org/doi/full/10.1056/NEJMoa1515724#t=abstrac...

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

#25

Post by jessriedel »

hx87 wrote: post #12
djsumdog wrote: post #2

I 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…

> The real bottleneck is in the number of residency slots, which hasn't changed in 20 years.

Aren't you just refering to the 20-year freeze on the number of medicare-financed residents? I believe the number of residents is still increasing through other funding. Or is there some other way to square your statement with this?:

> Medical school seniors scored a record number of available first-year slots in this year’s Main Residency Match... Continuing a 4-year growth trend, the number of available post-graduate year 1 (PGY-1) positions rose to 27,860 in 2016, 567 more spots than in 2015, and a record 18,668 U.S. allopathic medical school seniors registered for the match, 221 more than in 2015, according to data from the National Resident Matching Program (NRMP). Family medicine residency programs offered 3,238 positions in 2016, up from 3,195 in the 2015 match. Internal medicine experienced similar increases, with residency programs offering 7,024 positions this year, up from 6,770 positions in 2015.

http://www.mdedge.com/internalmedicinenews/article/107413/pr...

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

#28

Post by mv »

finid wrote: post #22
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…

But nurses are no different. We need to start addressing the leading cause of medical accidents - physicians/nurses sleep deprivation.

they are completely different. Where I work in cali nurses are full time working 3 or 4 twelve hour shifts a week. Overtime optional and highly compensated.

medical residents will routinely do back to back 24 hour shifts with no sleep and even the ICU attendings will do a week of every other day 24 hour shifts.

The 16 hour rule only applies to interns. Once you reach second year the rule is 80 hours a week averaged over four weeks. This means that 100 hour weeks still do happen.

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

#29

Post by squozzer »

devoply wrote: post #14
prodmerc wrote: post #8

The 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, bec…

Even though I've suggested other motives in play elsewhere, you are probably on to something.

Most doctors become doctors either as a childhood dream or to fulfill the expectations of others. Lots of pressure at an early age - and it only intensifies from there. Getting the grades, pre-med maybe, certainly biochem, then med school.

Residency is the home stretch to a lifelong commitment, feet don't fail me know, brass ring almost within reach...

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

#30

Post by shams93 »

mv wrote: post #28
finid wrote: post #22

Earlier quoted context omitted.

But nurses are no different. We need to start addressing the leading cause of medical accidents - physicians/nurses sleep deprivation.

they are completely different. Where I work in cali nurses are full time working 3 or 4 twelve hour shifts a week. Overtime optional and highly compensated. medical residents will routinely do back to back 24 hour shifts with no sleep and even the ICU attendings will do a week of every other day 24 hour shifts. The 16 hour rule only applies to interns. Once you reach second year the rule is 80 hours a week averaged o…

I was forced to do 100 hours a week for a company that had a sadistic culture of over work, you never get anything done, under those kind of hours unless you're doing stimulant drugs your brain just shuts down. I wonder how many doctors are also drug addicts just to make this kind of work intensity physically possible even?
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