|Frederick Winslow Taylor|
My friend and colleague, Dr. Michael Edmond, published a thoughtful essay in Annals of Internal Medicine titled Taylorized Medicine. The practice of medicine and the education of resident and student doctors have changed. The pressure of abiding by an 80 hour work week, the need to efficiently admit, treat and discharge patients, has added to the stress of medical training and has chipped away at the collegiality, banter and humor of working within a medical team. Inpatient medical care resembles a mechanized process of maximal efficiency, much like the field of scientific and industrial management pioneered by Frederick Winslow Taylor.
Effective July 2011, the ACGME will limit intern shifts to 16 hours, night float is limited to 6 consecutive nights and ‘strategic napping’ (yes, that term is actually used) is encouraged for residents taking overnight call. These recommendations are for sake of patient safety. This may be a noble aim, however, a timely a review published in the Annals of Internal Medicine acknowledges that there are significant limitations in the data supporting these measures.
While I believe in patient safety and in reducing work hours for residents, my hope is that the upcoming changes do not inadvertently dehumanize the patient-doctor encounter to that of a mere transaction. Were that to occur, then joy of medicine would be irrevocably altered.