Hi guys,
I remembered from a news article that they say misdiagnosis is the 6th leading cause of death! Then it made me to wonder, when doctors are making life-and-death decisions about people's health...why are they forced into grueling workloads especially during residency and internships? It not only would make fewer mistakes but would lead to lower malpractice insurance costs!
Why can't residencies, internships, and hospitals permit a maximum of 12 hour workdays or a 60 hour weeks? Why do they permit 18 or even 24 hour work shifts or anything beyond a 70 hour week? I understand how they want doctors to be alert and have stamina, but it sounds like hypocrisy that doctors lecture adequate sleep for their patients but not for themselves!!
Shouldn't doctors have a normal 40 hour week?!?
I would especially appreciate it if doctors and hospital management could elaborate why.
Asked by a potential medical student.
Paul
Jack, doctors are in high demand. It takes a lot of time and effort to become a doctor, and their are not enough doctors out their so that the work can be spread out evenly. And yes a lot of deaths are caused by misdiagnosis also medical mistakes by medical staff. If you are looking to become a doctor, or a nurse do it because that's what you want to do because with it comes a lot of responsibility and a lot of heart ache. The only thing that you will get to look forward to at work is celebrating your patience "bodily fluids" ( Means that they are doing good enough), and knowing that you are helping people and saving lives. Hope this helps - Paul
happy-scally
These unhealthy workloads are now illegal in Europe, and the limit is now 48 hours a week.
There are two reasons for the workloads: one is to make sure that junior doctors get enough experience to actually learn enough to be good doctors when they qualify, and the other is to make the hospital books balance. (Doctors' overtime is essentially free labor for the hospital.)
If your jurisdiction makes it illegal, then it won't happen, or if it does, people will lie about their hours. If hours are cut,the hospital will have to get more funding (from governments and insurance companies). To keep the standard of training, residencies and internships may have to be extended by a proportionate number of years, though UK civil servants claim that quality is more important than quantity.
MishMash
I would say lifestyle diseases are the leading cause of death. Many people are out there eating junk, white bread, smoking, drinking themselves silly and taking illegal drugs and expect doctors to fix them.
Residents often enjoy working the eighty hour week and they don't do 80 hours every week. They see it as a chance to learn - they are the only resident on in their specialty and they get to assess exciting emergency cases. Also when they are on 24 hour call they have a bed in the doctors quarters and do get to sleep - they are not working all the time.
I have worked with many residents and registrars who have stayed back after 5pm (even though they were not rostered on to do so) so that they could assess a new patient that was coming in from ER with a condition they had not seen before.
There is a shortage of doctors though, especially in country areas of Australia. Maybe if you qualify as a doctor, you might come over and help out.
John de Witt
Residents are pushed because it's training. They're highly supervised, and this is the place one learns to make difficult decisions quickly under adverse conditions, with the safety net of having a supervising physician attending. Also, you should get it out of your head that malpractice has much to do with malpractice costs. The two have very little relationship to each other. When you read about a multimillion dollar malpractice judgment against a doctor, it's a flip of the coin whether he actually did anything wrong (actually, if it's an obstetrician, the odds are somewhat greater that he didn't).
It would be very nice if doctors had more controlled hours, but people don't get sick on schedule, and they're downright nuts when it comes to deciding when they need after-hours care. Add to that the difficulty of people getting an appointment that doesn't stress job, family, and other schedules, and the hours are sure to remain crazy. Once you get to a clinical rotation, you'll understand: it only takes a few shifts in the ER, when it's 3 am, and your patient is a 3-year-old who's vomited twice, and mom's given him a bag of potato chips from the vending machine in the waiting room.
Misdiagnosis, by the way, isn't as big a problem as you'd think from an initial impression. Initial diagnoses are always tentative and based on statistical analysis. The trick is to keep an open mind and a backup plan handy. When you see articles like that, you can bet somebody has an ax to grind, and the "misdiagnosis" probably has little to do with the outcome in most circumstances.
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