Doesn't this level of overwork originate with one medical instructor, who was a habitual cocaine user and thought nothing of going without sleep? I remember reading this somewhere, but can't remember where.
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No Doctor Should Work 30 Hours Straight with No Sleep
61–70 of 208 posts
Re: No Doctor Should Work 30 Hours Straight with No Sleep
#62You 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.
Exactly. And it's not just airline pilots. Truck drivers have hours of service rules, too. So do railroad engineers.
Re: No Doctor Should Work 30 Hours Straight with No Sleep
#63The interesting part of this is that truck drivers are heavily regulated, as they should. They are forced to take breaks after driving a certain number of hours. Not sure exactly, but I think it's about 8 hours. The same treatment for doctors won't be a bad idea.
It's 11 out of 14 hours, then a 10 hour break.
https://www.fmcsa.dot.gov/sites/fmcsa.dot.gov/files/docs/Dri...
There's some additional rules about how many hours can accumulate over a certain period of days (the period is rolling, it doesn't reset).
Re: No Doctor Should Work 30 Hours Straight with No Sleep
#64The 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…
My wife's a second-year resident and it's pretty unbelievable how hard and how much they work. She's on her 18th straight day of working long days during the week and long nights during the weekend. Legally there's an 80-hour per week cap, but no resident would ever complain. They do 24 hour shifts, but never 30 hour ones, though other programs at her hospital do. I felt upset about her hours all through medical scho…
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 there's call.
I write this as I read more through your comment... the statement on the kids, medical training running your life... all true.
The other part, that I'm sure you can personally relate to, is "The Match". The "sorting hat" algorithm that all 4th-year med school students have to go through. For those unaware, the match dictates the program that a doctor candidate (MD or DO) must attend for residency. Given where my wife attended medical school, we already know that we're going to have to pack up and leave the home that we've established over 4 years since there are no residencies in our region. But since everything is done through "The Match", it's really a toss-up where in the country we end up (she applied to every program in the country since competition mandates that everybody do absolutely everything)... we'll be finding out in about 6 weeks where we will live come summertime. "Runs our lives"... so accurate.
I do what I can to support my wife through this endless process, but boy is it exhausting for everyone involved. I have no clue how she does it.
It truly is an enormous sacrifice of - really - some of the best (at least youthful) years of your life. Want to become a doctor? Say bye-bye to your 20s.
Edit: drawing context from another person who also commented on your post, we've also heard kids during second-half of residency can be a good route to go. We're thinking 3rd year ourselves.
Re: No Doctor Should Work 30 Hours Straight with No Sleep
#65Didn'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).
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.
Re: No Doctor Should Work 30 Hours Straight with No Sleep
#66The 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…
My wife's a second-year resident and it's pretty unbelievable how hard and how much they work. She's on her 18th straight day of working long days during the week and long nights during the weekend. Legally there's an 80-hour per week cap, but no resident would ever complain. They do 24 hour shifts, but never 30 hour ones, though other programs at her hospital do. I felt upset about her hours all through medical scho…
A family member is the administrative director of a demanding internal medicine residency program here in Canada, and I can say from experience nearly all the residents take maternity or paternity leave during their residency. The program is incredibly accommodating to new parents, partially driven by Canada's strong parental leave laws, but mostly because they recognize doctors are people too. From what I hear US based programs haven't come to the same realization.
Re: No Doctor Should Work 30 Hours Straight with No Sleep
#67Earlier quoted context omitted.
I'm surrounded by doctors and I don't know any that abuse drugs, other than alcohol and maybe weed. I believe they are just so busy and so overworked that they are constantly moving around / doing paperwork. The demands of the job keep them going.
You don't know any doctors that use drugs, but you do know of some that do weed. I'm laughing... Is weed a kind of tea, or is that an energy bar?
He said abuse, not use.
Re: No Doctor Should Work 30 Hours Straight with No Sleep
#68Earlier quoted context omitted.
But nurses are no different. We need to start addressing the leading cause of medical accidents - physicians/nurses sleep deprivation.
No, we should direct all the hate at lawyers asking for more than 250k for malpractice
Doctor amputates the wrong leg. How much in compensation is that worth in your mind? There should never be an award more than 250k? I disagree. My wife is a psychiatrist that works in patient. She got a transfer from another hospital who was on 32 drugs. That's clear negligence and should be a malpractice suit but no lawyer will take the case. It's not clear cut enogh. In recent years the pendulum has swung in the other direction. There isn't enough access to the court system for patients wronged by the medical community.
Re: No Doctor Should Work 30 Hours Straight with No Sleep
#69The 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?
Re: No Doctor Should Work 30 Hours Straight with No Sleep
#70Didn'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).
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.
Or doctor/nurse practitioner pairs, since training and paying a NP is far cheaper.