Sorry, I incorrectly assumed you were in medicine so the whole "this is all based on B.S. data" would have been self-evident.
The data from which the peer-reviewed empirical studies is flawed. I know, because I am the data. I -- and almost every other surgical resident I know -- routinely falsifies their work hours. Why we do this is a _long_ topic for another thread.
Please confirm with your local surgical resident; if you can find her. ;-)
Throwaway because it was so disheartening to read this perspective.
> The first is that 16 hrs is too long of a shift to be working throughout, as is 24 hrs. What I'd tell you is that hardly ever would a doctor be working during the entirety of either of those shifts.
This is very location, hospital, and speciality specific. Most surgical residents would say the opposite.
> Secondly, do not underestimate the danger of hand-offs
Hey, why don't we work on better handoffs. Other fields (even with-in medicine) seem to manage. Maybe we should mine the airlines industry again for good ideas. The dichotomy of 16 vs 24 hours to me is a false choice.
> There are surgeons graduating after 5 years of ENT training... who have not had enough experience to become attendings at the places where they are interviewing.
For what it's worth, surgical sub-specialists like ENTs will do at least 2-3 times as many hours in training as a family medicine doc or pediatrician. Make the training an extra year and pay a better god damn salary if they really aren't trained well enough. Right now the system is designed around cramming as much pain and suffering as a human can withstand in their training to get the most value for the hospital. There's a reason why some ~25+% of general surgery residents leave the field completely.
> The third point is about how healthcare functions in the country, specifically around large hospitals
I mean, I call bullshit and I see this logic all the time from fellow physicians who try to make the cost argument from the floor. We pay NPs and PAs to work exactly these shifts, and hours. Why not residents?
> conclusion that 24hrs is truly worse than 16hrs for patient outcomes
I completely disagree that the late night hours have done anything towards making me a better doctor. And I'm truly sorry if I came off as feisty but the whole discussion is so frustrating to me because I think it misses the big picture. This change by ACGME signals the wrong direction we need to be going in how we treat young doctors.
At some point, the aggregate weight of non-cancellable student loans (~240k on average now?), anti-competitive labor market (that went to the supreme court), inhuman hours (that would be illegal for a pilot or truck driver to do), relatively shitty pay (my SO is in tech and earns 2x what most primary care physicians do in 1/2 the hours) will be too much. They'll quit, and find other ways to "make a difference."
I can't put a pillow in a pillow case after 24 hours. Do you really want me stitching up your mom?
>Also, a 28 hour shift doesn't mean that the doctor is working (or even awake) the entire time - they're on-shift, but there are periods of downtime. It's not necessarily 28 hours of constant activity.
Do you really want me operating on your Mom after 28 hours? I wouldn't. I can't tell you the amount of times a fellow resident has got in a car crash, or made a mistake related to patient care because of lack of sleep.
Also, let me clear up the "periods of downtime" part for you. For the last 6 call nights, I got a grand total of two hours sleep.
Honestly, I created a throwaway specifically to reply to many of (what are in my opinion) very misguided opinions on how these types of hours effect quality of care.
The data from which the peer-reviewed empirical studies is flawed. I know, because I am the data. I -- and almost every other surgical resident I know -- routinely falsifies their work hours. Why we do this is a _long_ topic for another thread.
Please confirm with your local surgical resident; if you can find her. ;-)