Sunday, August 24, 2003

A reader sent a comment regarding an earlier post.
I've heard repeatedly that requiring doctors to work to exhaustion trains them in the ability to work while exhausted, and to provide decent care while doing so. I've heard it enough that I'm willing to believe its possible. What I'm not willing to believe is that its necessary, any more than I was willing to believe, this past week, that I should drive directly from Boston to Baltimore, without stopping, just so that I could get the experience of making driving decisions while exhausted...
The purpose of a residency program is to train physicians, over a period of several years, to treat patients so when they become Big Doctors they are able to do their jobs without supervision. There are no work hour limits for Big Doctors in the real world, so the 80 hour limit may create an artificial environment for the residents. Under these guidelines a resident must leave the hospital after a night of call, even if they have slept all night. Is this how the real world works?
As far as it being "necessary", all physicians, from time to time, must make quick decisions while tired. Would you rather them do it for the first time while they have the supervision of a training program surrounding them, or when they are out on their own without the ACGME looking over their timecard.
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