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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

#91

Post by user5994461 »

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…

> 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 directly to overworked doctors.

There is a "shortage" of doctors and crazy hours in countries with free education, no student loan system and insurance is ensured by the country for all citizens.

So, no, these issues are not the whole story (which doesn't mean they are not issues).

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

#92

Post by mcv »

pdxandi wrote: post #34
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…

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…

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 lives depend people being awake enough to do their job safely. People responsible for that should not merely be fired, but locked up.

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

#93

Post by rileyteige »

user5994461 wrote: post #75
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…

> 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. How does this work out in the long…

Well I can't say for sure about post-residency, but during the programs the shift scheduling was consistent all four years (some months you work the day 12-hour shift, other months you work the night 12-hour shift). The only thing that changed was during 3rd and 4th year, the call schedule was a bit more relaxed (after all they have to prep for another round of board exams).

As for burnout, alcoholism is relatively high among many medical specialties: https://www.sciencedaily.com/releases/2016/03/160314111353.h...

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

#94

Post by finid »

rileyteige wrote: post #76
finid wrote: post #58

The 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.

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.

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

#95

Post by realitygrill »

module0000 wrote: post #89
devoply wrote: post #14

Earlier quoted context omitted.

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.

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

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

#96

Post by finid »

Mz wrote: post #78
rileyteige wrote: post #76

Earlier quoted context omitted.

While I agree with you, I have two words: Doctor shortage.

Yes, and preventing health problems by preventing medical errors would go a long way towards easing up the demand for medical care.

So you want to bring up the problem that over medication causes...

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

#97

Post by koolba »

pdxandi wrote: post #34
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…

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…

Why can't you have children? Would it completely throw her off her eventual completion of her residency or just delay it?

All women deal with it differently, but most are able to function within their normal bounds until at least the six or seventh month.

> Writing this comment makes me realize how painful it feels at times that her medical training runs our lives.

s/runs/ruins/?

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

#98

Post by wildmusings »

mcv wrote: post #92
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…

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.

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

#99

Post by Mz »

finid wrote: post #96
Mz wrote: post #78

Earlier quoted context omitted.

Yes, and preventing health problems by preventing medical errors would go a long way towards easing up the demand for medical care.

So you want to bring up the problem that over medication causes...

I am not sure what the point of your cryptic reply is, but as someone who has gotten off all medication for my condition, I have no problem saying that there is certainly room for improvement in that regard.

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

#100

Post by rileyteige »

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.

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.

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