Despite concerns from the public about safety, the private group that oversees physician training voted to allow young doctors to work shifts as long as 28 hours. The new rules, which begin on July 1, relax work restrictions put in place in 2011, when mounting evidence showed that exhausted residents — the term for doctors in training — were endangering both patients and themselves. Currently, first-year residents are restricted to 16-hour shifts. Leaders of the Accreditation Council for Graduate Medical Education said the work limits for first-year residents, known as interns, needed to be extended to match the 28-hour shifts now allowed for more experienced trainees. They said it was harming interns’ education by reducing their time in the hospital.
Surgeons had been especially critical of the 16-hour limits, saying that at times interns were forced to leave the surgical team during an operation to avoid breaking the rules. The change was called “reckless” by Public Citizen, the national consumer group that had been working with concerned physicians to try to defeat the proposal.
Residents often work more hours than they report on paper, either because of pressure by the attending physicians or, as the article states in the case of surgeons, having to take a break in the middle of a procedure. The 24 hours shift sounds bad, but I'm sure it happens off the record a lot. Residency is fucking hard and miserable, and at a certain point stacking a few more hours won't make a difference.. you're already sleep deprived with 16 hours shifts
t. med student
William Hernandez
enjoy your medical accidents
Jonathan Ross
Sometimes I feel glad I'm not a stemfag doctor big shot
Aiden Brooks
Yes, unless you want to be killed because you go got misdiadgnosed or got prescribed the wong treatment. Also younger doctors are under considerably more pressure than the seniors used to be at the same age: - more administrative work - more demanding patients - more technicalities to master - more attention to cost of care required - more violent/stupid shitskins
It's no wonder why so many of them are killing themselves.
Adam Miller
They are killing themselves? Got any sources kind sir?
Isaiah Ross
>should we allow patients' lives to be put at risk well, the world is overpopulated
Liam Perry
In most hospitals here there are rooms where medical personnel can sleep, it helps a bit.
Oliver Nguyen
This is true. They don't work 24 hrs straight. They doze off any chance they get. Also, they fuck nurses like rabbits. You wouldn't believe it man.
Ryan Perry
You'd think that even with all the risks of making doctors work for that long, people would say no to this retarded shit.
Even without any risks, they're fucking human beings who work harder and in one of the most important fields of a functioning society. I dont know why so many people treat these workers with respect.
That being said, maybe I'm wrong and 24 hour shifts are somehow manageable.
Charles Harris
There are a shitload of article about it online, google it. It's overall a x2 risk of killing yourself in the US and 3x in France.
It's especially commong among the med students, you can't really talk about it though because they will basically declare you "unfit" for practice if you display """"mental illness"""". And that's just the one killing themselves, patients have no idea how many of their doctors are alcoholic or drug users which is aggravated because the hospitals and clinics get filled parasitic "managers" whose only goal is to maximize productivity like in a factory while conditions of practice and security are in free fall.
Finally that's just the beginning, with the extreme feminization of the profession it will only get worse because women are far less stoic than men.
Jaxson Gray
degenerate scum
Carson Sullivan
there's a lot of similarity between pilots and doctors.
Elijah Wilson
not really. Society mostly jews the service because "health is too expensive"
you have to wonder, if they're overworked so much couldn't you bring more people into the profession?
Lucas Gomez
>That being said, maybe I'm wrong and 24 hour shifts are somehow manageable.
One 24 hour shift is manageable, problem is when you have 2 in a week and your sleep rythm is fucked.
But anyway it's not the problem really, it comes with the job, you need to have doctors 24h/day and there is no magic to fix that, the issue is more that the management is more and more clueless about the job, hospitals used to be led by actual doctors, now you have more and more of extra-medical staff, the very same people asking you to fill 3 pages of paperwork for each patient for the government/insurances instead of actually taking care of patient.
It's a bit like a military unit led by bureaucrats with no battlefield experience.
Cameron Phillips
You don't have to be a stemfag doctor bigshot, you just have to not be a doctor.
Levi Watson
Yup, comfy investment banking 12 hour days here
Matthew Parker
Nailed it!
Thomas Sanchez
This whole issue is bullshit
t. medfag
If calls are too long for doctors, that means there is a shortage of doctors. The same thing is happening here, on a much bigger scale. 40 years ago we had 48 and 72 hour calls, but no one expected the juniors to actually work for even half of that time. A call would have three or four teams of doctors/students/interns/registrars but only would would actually be expected to be on duty at any one time, the rest would be able to eat and sleep.
Then after apartheid ended we entered a doctor shortage, and it wasn't feasible to have so many doctors hanging around while the others were overloaded, so instead of having them do three 72 hour calls a month where they would only end up actually doing stuff for around 130 hours, they cut the total for the call to one where doctors would not be able to find time to sleep or eat, hence the 48 or 24 hour calls, where even though it appears they are working the same amount of hours on paper, they often end up doing calls with only a single hour off to sleep, resulting in them having a workload that is 30% more than previous generations of doctors while having 90% less time off on calls
Jaxon Phillips
Gee, who controls the medical establishment?
Gee, how is American's health?
Isaiah Diaz
>tfw was set to be a doctor but dropped out of college and now starting a nurse degree at 22
I regret everything and threads like these hurt.
Anthony Watson
100% correct. Modern residents face declining remuneration, reduced teaching, greater administrative duties and a technically more difficult job than 20 years ago.
These guys who've worked 24 hours are fully capable of killing a patient due to thier fatigue.
Having the resident leave the OR (when they're usually just holding a retractor anyway) is a pretty small price to pay for patient safety.
t. Primary Care Physician
John Lopez
i'm a 2nd year resident. this rule change is for 1st year residents. every program that i know of has 28 hour call/shifts or 2nd and 3rd years. it's doable and not awful. Adrenaline helps a lot, and by the 19-20th hours the day teams start to come in and help out.
it's fine. i find it's actually better for patient care. handoffs are dangerous.
Elijah Thomas
The root of the problem is that the AMA artificially keeps the numbers of new doctors low to inflate wages. They are one of the textbook examples of a union that causes far more problems than they solve.
Angel Kelly
I don't think anyone's judgment is after 24 hours without sleep. The issues I have is how those kinds of shifts fuck up your sleeping patterns and lead to burnout and impaired judgment and deteriorating mental health over time.
I'm not a doctor, but I used to work in software development. I've seen what happens to morale and mental health at studios that overuse "crunch time." If crunch is for a week or two surrounding a product's ship date so that you can polish everything and have key people on-hand to address any major bugs that crop up, that's fine. But a lot of studios (especially game studios) force people into a perma-crunch where they work 80+ hour weeks for months on end (Cloud Imperium Games, I'm looking at you). All of my friends who have worked under those conditions have found that their productivity, motivation, and morale suffered severely. And studios where that is the norm end up with incredibly high turnover rates because people just burn out.
You have the same number of available doctors regardless of how long individual shifts are. Why not max shifts at 12 hours and have some people working the night shift for a rotation of say, four months, and then switch to the day while the day doc switch to night. Then you only have people's sleep schedules being fucked up a few times a year instead of a few times a week.
Charles Hernandez
forgot the word "impaired" in line 1
Zachary Mitchell
Nope, that's absolutely insane. If I went into hospital and knew the doctor treating me had been working for 24 hours, I'd want another doctor. Nobody is functioning close to 100% capacity at that point unless they're popping adderall or modafinil or something.
Kayden Morris
i disagre, i think its the exact opposite. what the fuck does doctor know about logistics? its the overall shortage of doctors due to a constant drain to the private sector. private provision with public money is a way out.
Ayden Powell
this, I was in the emergency room and had a minor procedure done, but with the surgeon saying "I'm just finishing up a 24 hour shift, let's do this" my confidence was waning to say the least
Adrian Stewart
have i dun goofed just entering pre-med?
Ian Wood
Because you didn't experience it first hand. These managers are not the symptom of an healthcare system wanting to be "better", it's just about reducing costs no matter the results.
>private provision with public money is a way out. They are not private position and that's the biggest problem, they are public servants, basically glorified grunt of the minister.
I will take the example of France because that's the one I know the best: We have a mixed private/public sector, basically the state pays 2/3 of the medical acts/drugs and the insurances pay the 1/3 remaining, the counterpart is that prices are fixed by the government by negotation.
Thing is that since there are 2 majors problems today: 1) boomers skyrocketted the debt by spending recklessly in bullshit programs during the last 60 years. 2) the number of seniors requiring care is growing exponentially and will reach a between 2020 and
Now instead of cutting straight bullshit program the government tries to maintain it all but by imposing cuts on everything, they are unironically reducing the funding of hospitals drastically while there are more and more ill people, and it's not done efficiently because as I said the thing is maneuvered by the Minister, meaning it's heavily centralized, rigid and rarely adapted to local realities.
I don't say you can't make savings, there are efficiency problems (especially in the public sector) but the way it is done is absurd, you don't make things better by constantly harassing the healing staff with more and more paper and by decision taken in political commities, I don't even speak about the cost of those technocrats.
There is the rising judicialization of care too, fucking lawmakers are shitting new reglementations every fucking year and we are progressively but surely turning in little USA where you can't be touched by a doctor before having signed a book.
Logan Mitchell
British medical student here: We've just had a new contract pushed through for our junior doctors that aims to strictly limit us to set shifts - classically you go home when your work is done but they're trying to impose a more shift-based approach onto us.We work 12h shifts max now for safety reasons but often you bleed out a little extra time on either end.
The problem with these changes is that hospitals are very adaptable, changes are made unofficially between colleagues all the time and new circumstances adapted to so the more restrictions put on the hospital from above, the less capable it is as an entity in adapting to externalities - they inherently dismiss the fact that hospital are full of independent professionals with the agency to make choices in the running of their own lives and the running of the hospital. Tyrannical managers don't seem to understand these facts - politicians, being tyrannical manager managers, even less so.
The big issue: The senior doctors working now used to work 72h on call shifts as juniors - juniors now only 12h at a time - so when the current cohort of juniors become senior doctors they will do so with literally thousands of hours less experience - thus the question is - what is less good for patient care?
Tired juniors or inexperienced seniors? It's probably the latter.
