Comments on: Work hours – the problems of bureaucracy

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[...] DB’s Medical Rants » Work hours – the problems of bureaucracy [...]

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Mon, 09 Mar 2009 16:18:12 +0000

[...] One resident told me about caring for a child who was dying. She had taken care of this child for 10 or 12 days and was on call when it became clear that the child was going to die in the next few hours. But this resident was supposed …Read More [...]

By: Patrick B

Patrick B — Fri, 06 Mar 2009 20:06:45 +0000

DB, you hit the nail on the head when you say the problem is in the excessive rigidity. I think the 80 hour limit is fine–it is an average over 4 weeks, and if you have a busy week, there is a good chance you’ll have a slower week. I don’t know–it just always seems to work out at my program.

The 30-hour rule, though, is inviolable, and like most inviolable rules, it’s a bad one. I like the idea–after 30 hours, I’m not thinking so clearly. And most people should sleep after 30 hours. But I’ve been hounded out of the hospital because I wanted to stay and eat lunch! Sometimes there is some great learning opportunity that shouldn’t be missed. Most of the time it is good to leave at 30 hours, and there is no reason that shouldn’t be the norm. But it is not _always_ the best thing. The rules should take such things into account.

By: Jared

Jared — Thu, 05 Mar 2009 23:42:32 +0000

DB, I have no idea if you are a follower of TED talks, but this one on the loss of wisdom is one of the best TED talks I have watched in the past 2 years.

http://www.ted.com/talks/barry_schwartz_on_our_loss_of_wisdom.html

It speaks also to the problem of work hour restrictions. Errors are made, and the root cause analysis is probably correct, but the path of how we got to the root cause is faulty. Watch it. It’s quite good.