I walked uphill, in the snow, both ways…
Things have changed dramatically in medicine over the past decade, and effects of this change are just now starting to trickle down to where the general public is aware of them.
For those of you not in the business, resident physicians had work hours cut to 80 per week back in 2003. Prior to that, these trainee physicians sometimes worked 100, or even 120 hours per week. Of course, with the normal lag time such new restrictions have, the law was not really enforced with any strictness until around 2007-2008. So it’s only in the past 4-5 years that doctors have been training less than in previous years.
Does this have an effect on the quality of doctor you’ll see as a patient? I trained right as the hour change was being enforced, and I wholeheartedly say “Yes!”
I understand that working 120 hours a week is absurd. It is. I’ve worked some 100 hour weeks (the 80 hour standard is average over a month, so you can still have some busy weeks in there), and you really don’t do anything but eat, sleep, and work.
80 hours, however, gives you plenty of time to clean the house, study, and even take on a hobby or two. I ran a half marathon in residency, so clearly I did have some free time. I’m super-slow, by the way, so those were some looong training runs!
But now there is talk of cutting the work week even more. This is a terrible idea- let me explain. When the initial cuts took place, people thought of going into tougher (i.e. longer hours) specialties such as surgery that never would have thought of it before. And with the new rule in place, you literally get kicked out of the hospital if you’re over hours. Meaning someone else picks up the slack on the work you didn’t get done. So there’s no motivation to become more efficient. And there’s also no longer the mentality of “This is my patient, and I will take care of him/her until the job is done.”
Instead we have a new paradigm of shift work. The night team comes on, and the day team leaves. New doctors (and I’m speaking generally here. There are, of course, exceptions) no longer have the same sense of ownership and responsibility. And if they do, they get sent home regardless of their dedication.
So I ask you: do you want a doctor who’s learned to be efficient, so that he can get the work done and get you both home in a timely manner, and one that will stay to see the problem through? Or one who works until his shift is over?