Monday, July 23, 2007

A Wall Street Journal article reports old docs think new docs (residents) aren't getting the education they need because their weekly work hours are limited to 80 hours a week. That's right, 80 hours. It's actually not that good. That's an average of 80 hours over two weeks. So one could work 100 one week and 60 the next and still be compliant.

Old docs will complain about new docs not being altruistic. What seems to be their definition of altruism? Not working 150+ hours a week like they did in their training. Seems reasonable, right? You have to do it because I did! Here are the "main" findings:

  • Eighty-seven percent of the doctors thought continuity of care had worsened, and 75% thought the physician-patient relationship had deteriorated.
  • Sixty-six percent said residents’ education had gotten worse, 73% said residents were less accountable to patients and 57% said residents’ ability to place patient needs above their own had declined.
  • Half thought residents’ well being improved. But 56% of the teaching faculty found teaching less satisfying.
I find it interesting that in a system in which residents are paid about 20% of the staff to cover nights, weekends, holidays and everything in between, that those in charge are complaining about being able to have less of the resident.

Teaching hospitals provide a great service to our country in terms of educating our future doctors. But don't think it is altruism on their part. They get 5 residents for the price of 1 staff and used to be able to work them at their whim (and bottom line). Now that there is a 'limit' of 80 hours (ha! again I say ha!) somehow it's a detriment to patients and resident education.

Finally, the 80 hours are constantly ignored and subtly understood that that is the way the game is played. Doctors now are being paid less (don't believe big insurance), for more with less kudos than when "old docs" had their training with patients paying cash, receiving gifts and not having to answer to anyone but themselves.

UPDATE: Great response over at Over!My!Med!Body giving a first hand med student perspective on the whole "you have to because we had to" residency issue. Please read. Well written and shows the other side of the coin.


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