Health Buzz: Sleep Breaks for Medical Residents and Other Health News

rest for residents

How can a sane group of Dr.'s think that a new Dr. needs no sleep. Truck drivers are mandated to sleep not drive so they don't kill on the hiways, so should Dr.'s so they don't kill in hospitals.

rest for residents

Let's treat this on a purely logical decision. Would you go out and hire a person to care for your health who has routinely abused his own health by giving up a scientifically proven method of restoration & healing, known as sleep? Would you allow a system that pushes people into unhealthy use of drug supplements to stay awake to dictate your plan for good health, emotional well-being?

Or would you pass by that choice and move on to a person who can guide you along a healthy path because they are on one themselves.

I don't want to see anybody pushed beyond exhaustion for any reason, let alone a person I've chosen to help me look after my health.

Sure, you can say this is an oversimplification - almost everything is. But don't tell me what to do unless you are doing it first for yourself.

Sleep well.

If residents, surgeons, or anyone else needs to work an 80 hour week they can.

But that should *never* include working 30 hour shifts that might only include a catnap or two.

Study after study has found that reflexes, judgment, memory, thought and long-term learning--all these slow down after too long without sleep. There's no way around this. Unless residents are allowed to take Provigil?

There has to be some way to get the math to work out. If they need 15 hour days, then every 48 hours a resident should have 3 separate 5 hour rests (whatever the minimum refresh time is). That gives 15 hours/day without the loss of higher decision-making parts of the brain.

rest

What is interesting, and really not portrayed in many popular arguments about resident work hours, is that once a physician is done with training, there are no limits on how long the day is. Most people not aware of how much goes into their care. If you really think you are getting a "well-rested physician" performing your operation, you are most likely mistaken. There aren't enough surgeons to do the work necessary. Most importantly, despite what has been seen in generalized sleep studies, multiple analyses of the change to the 80-hour work week has yet to demonstrate an improvement in patient outcomes. Yes, residents get more time outside the hospital, but at what cost? A five year residency at 120 hr/week is equivalent in experience to a seven and a half year residency at 80 hr/week. The physicians coming out will not be as well trained. they will have lost almost a third of the knowledge and experience doctors who graduated 20 years ago did.

Those who want legislators to "step in" are short sighted- sue more doctors and make an already thankless job less desirable? never a good idea.

work hour restriction

During my residency I noticed very few residents report their hours truthfully. Since there isn't anyone else to take care of the patients, we can't simply leave. I hear a lot of the old guard making the argument about continuity of care, and they have a point. However, the job has gotten more complex, the patients more numerous, and the documentation more extensive. If you combine these factors with the fact that most residents actually work over 80 hours quite frequently, then the old rules just don't apply. Having said all this, naps are quite frankly, an insane idea that could never work. Although if they implement it, I'll be the first to give it a shot.

No hope for America

Our problem isn't the hours doctors spend in training, it's the expectation of the public. Physicians train years and give up their lives to take care of others and are expected to be super-human in knowledge. What are they rewarded with? Great pay, yes, for now. But with socialized health care right around the corner they risk losing their practices because prices are just too high. I KNOW physicians that say if they had to accept medicare and medicaid patients only, they would have to quit medicine. Physicians are also burdened with the ever present fear that a disgruntled patient will sue for malpractice. There's NO glory left for physicians in America and we should feel privileged to know we can jump in our cars and go to the emergency department whenever we want. If Americans want their physicians to be 'perfect' maybe they should back off, take it easy on them, remember they're human too and just let them do their job!

Your Doctor

I am a Physician in Private practice and been so for over 20 years. If society wants just any doctor to take care of them 24-7 they are in for a rude awakening.

There are not enough doctors to go around, folks are living longer and their case mix are more complex.

Let me tell you, if I had not had the long hours of internship and residency I could not have survived in practice. On call every other night, full load days that followed for years on end!!!

Some times I wonder, why in the world I did it. And then the beeper goes off and is Mrs. ERTYYUUIIO ( HIPAA regs. ) so sweet and so sick, all I can do it to relieve sometimes and comfort always.

Will see what the bright minds will bring. The way I see it we are doomed.

Re: Care

"Medical schools are getting fewer applicants and residency programs are falling short of filling all their slots for new docs."

Actually applicants are up and there have been open residency slots for over a decade. There are just more people using the ER as their primary physician.

Care

You are all crazy if you think there are enough MD's around that you can be assured that you will see a "well rested physician" when you hit the ER. Medical schools are getting fewer applicants and residency programs are falling short of filling all their slots for new docs.

I think Christine has a point: You bring your child into the ER and a surgeon spends an hour diagnosing acute appendicitis, explaining the surgery and scheduling the procedure. He then looks at his watch and tells you his time is up and Dr. B will meet you in the OR and do the operation.

The public won't accept that form of treatment and lawyers would have an even bigger field day.

"continuity of care"

R U Crazy Christine? Do you have a death wish? Or, do you just think you are a comedienne?

Your comment makes NO SENSE!