No Doctor Should Work 30 Hours Straight with No Sleep • Hacker News Board

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

#81

Post by rileyteige » Tue, Dec 20, 2016, 10:01 PM UTC

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 medicine fields. Too many patients, not enough doctors.

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

#82

Post by matryoshka4811 » Tue, Dec 20, 2016, 10:01 PM UTC

It's hard to comprehend how many hours a doctor can keep going unless you see them everyday. My mother is an OBGYN. I remember growing up surrounded by MCAT and medical school books and the residency nights when she wasn't home when I went to sleep and when I woke up. I don't really remember when the doctor lifestyle wasn't a dominant part of how my immediately family functioned. (She had both of my siblings during her residency.)

And now, after she's been in practice for almost two decades, it really isn't much different. She's the head OB at a hospital/clinic that is the only one for several counties. She gets multiple cases a year when women show up in labor that she's never seen before. She's had to report multiple births to child services because the mother is an addict. On a personal level, it means that she never makes it to both Thanksgiving and Christmas, sometimes neither, and she's on call pretty much all the time.

All of this to say that she's inspiring really. I've never known someone who works harder or more tirelessly. I worry though that she'll work herself to death. Even then, I know she won't regret any of it.

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

#83

Post by 1888franklin » Tue, Dec 20, 2016, 10:02 PM UTC

Moshe_Silnorin wrote: post #73

pdxandi wrote: post #34

Earlier quoted context omitted.

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…

If you're worried about the effects of your age on your child, why not freeze her eggs and your sperm?

yeah, why not? nbd.

smh. "freezing eggs" is not a trivial solution.

https://www.theguardian.com/commentisfree/2015/oct/21/women-...

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

#84

Post by pdxandi » Tue, Dec 20, 2016, 10:02 PM UTC

rileyteige wrote: post #64

pdxandi wrote: post #34

Earlier quoted context omitted.

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 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 visualize your options.

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

#85

Post by parenteral » Tue, Dec 20, 2016, 10:03 PM UTC

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'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 having weekends off, but I prefer my current schedule.

I think I'm pretty well-paid, but are there better/easier ways to make money? Yes, of course. My college roommate probably makes more than me and my understanding is that he just sits in meetings and adjusts Excel spreadsheets all day managing someone else's money. But hey, whatever. I could work at night instead of the day, it would be easier (no discharges), and I would make over 430k. But I don't want to do that. Instead, I work with a residency program and get to teach, which is very rewarding.

I think overall it's just a matter of perspective and expectations.

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

#86

Post by pdxandi » Tue, Dec 20, 2016, 10:06 PM UTC

azsromej wrote: post #59

pdxandi wrote: post #34

Earlier quoted context omitted.

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…

My wife's in her final year of residency, so I know what you mean. I work from home in part to be around when she's off, but the demands of the lifestyle are especially clear when you see neighbors pulling into driveways at 5:30pm, friends enjoying a full weekend, vacations, and having several days off around the holidays. Residency, by not granting you those things that people normally take for granted, helps you ap…

I'm in the exact same boat. I work remotely and even though I've had a few job offers, one last night actually, I feel it's more important to have my flexibility here so I can see my wife when she's home. I find it especially helpful when she's on night shifts when her at-home time is <8 hours; I can move my day around hers to make meals and help wake her with coffee.

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

#87

Post by user5994461 » Tue, Dec 20, 2016, 10:06 PM UTC

minimuffins wrote: post #51

Learning about new ways that our medical industry is totally dysfunctional is baffling and infuriating. It seems to be an inexhaustible well of misery for workers and patients alike. These conditions are like something out of a 19th century factory town. One more way the US healthcare system is a ridiculous anachronism. My first questions are 1) Is sleep deprivation and the generally toxic work culture for doctors an…

1) It seems pretty bad in France too, judging from the few friends I have in medicine.

2) Like everywhere else. Do your hours and leave. If the business fails, too bad for it.

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

#88

Post by TheOneTrueKyle » Tue, Dec 20, 2016, 10:07 PM UTC

parenteral wrote: post #85

TheOneTrueKyle wrote: post #69

Earlier 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…

Sounds like you really enjoy what you do!

I hear about doctors like you, but I have never experienced someone like it in real life.

Maybe one day.

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

#89

Post by module0000 » Tue, Dec 20, 2016, 10:08 PM UTC

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…

A very soldier-worthy attitude to be admired.

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

#90

Post by parenteral » Tue, Dec 20, 2016, 10:09 PM UTC

venomsnake wrote: post #72

finid wrote: post #27

30-hours of non-stop work is almost 4 days of work, assuming 8 hours per day. Next time you read that a surgeon left one of his/her tools inside a patient, now you know why.

I would probably trust the worst student in a medical class when sober and well rested more than the even the best doctor after being awake for 30 hours. Mistakes will be made and people will die. After mission critical all nighter you also need 2 days at least to be able to recuperate.

I'm a doctor and I dispute this. I'm not advocating for long work hours or saying that it's healthy/OK. But the "worst students" in my assessment are people that I wouldn't trust to care for my loved ones at all and I would definitely take my weary-eyed trusted colleagues over the former any day. It's a very long discussion, but there are some really bad doctors out there who get by because most mistakes don't cause obvious harm.

Also, the body that oversees residency programs is going to relax duty-hours restrictions since they've studied it now and there's no difference in outcomes or resident satisfaction when they eliminate the 80-hour restriction.