Big changes took foot last month in teaching hospital across the USA.
Gone, are the days, of 'hospital hazing' the interns. The 30-hour overnight shifts for interns have been abolished. I still remember the long days (not so) fondly.
Interns, nationwide, are now limited to 16 hour shifts, an 80 hour work-week and 1 day off in 7. The changes were contentious and evolved with much debate and opposition from nearly every major medical organization and from the majority of residency-program directors.
Unfortunately, there is scant robust evidence to support that duty hour restrictions will necessarily result in a safer patient care environment. This last point is nicely explored in a recent New York Times Magazine article.
As pointed out in the article, work hour restrictions may not be sufficient to ensure greater patient safety across American hospitals. The duty hours must be applied uniformly, supervision by senior physicians must be present, sign-outs at shift change must be systematic and meticulous, and medical records (electronic) with medication safety alerts must be in widespread use. All of these limit errors in medical practice and none are sufficient when applied in isolation.
Perhaps, when all of these factors are in place, we can then reap the benefits of a more humane system of training young doctors, one that also benefits patients by providing a safer environment of care.
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| Photo: New York Times Magazine |
Interns, nationwide, are now limited to 16 hour shifts, an 80 hour work-week and 1 day off in 7. The changes were contentious and evolved with much debate and opposition from nearly every major medical organization and from the majority of residency-program directors.
Unfortunately, there is scant robust evidence to support that duty hour restrictions will necessarily result in a safer patient care environment. This last point is nicely explored in a recent New York Times Magazine article.
As pointed out in the article, work hour restrictions may not be sufficient to ensure greater patient safety across American hospitals. The duty hours must be applied uniformly, supervision by senior physicians must be present, sign-outs at shift change must be systematic and meticulous, and medical records (electronic) with medication safety alerts must be in widespread use. All of these limit errors in medical practice and none are sufficient when applied in isolation.
Perhaps, when all of these factors are in place, we can then reap the benefits of a more humane system of training young doctors, one that also benefits patients by providing a safer environment of care.
