Saturday, January 1, 2011

Time for new physicians to have normal schedules

This news story reports the consequences of surgeons and other physicians working with sleep fatigue.

Maybe there was a time when students completing their medical educations worked long hospital shifts for some reason. Maybe it was some kind of rite of passage. But, in my opinion, all physicians (and other medical professionals) owe it to their patients, their institutions and themselves to work a normal schedule. This is not like students at law schools being required to provide some free legal services prior to graduation.

In my opinion, these are the likely consequences of medical students being required to work excessively long shifts prior to completion of their degrees.

1) Unnecessary risks of medical errors placing patients at medical risks and institutions at financial risks.

2) New physicians becoming alienated from sources of administrative authority, making future collaborations with hospital administrators more difficult.

3) The conclusion from one's required educational experiences that it is okay to work in an impaired condition.

Would we want new pilots preparing to be employed by commercial airlines to be required to fly and land aircrafts full of passengers to demonstrate their ability to function when deprived of needed sleep? It should not be necessary for patients to call their doctor's office asking whether he or she is scheduled to be on call the night before a scheduled surgery. Legislation should not be required to require hospitals to assure that their employees are not sleep deprived. It should not be necessary to train surgeons that they should not be performing surgery when half asleep. There is a statement in the news story attributed to Dr. Charles A. Czeisler saying that, "Asking a surgeon to decide whether they're fit to perform elective surgery after having been up all night would be like asking a bartender asking somebody who's legally drunk whether they can safely drive home." If what this statement suggests is true of even a small minority of physicians it is a shocking reflection on medical professionalism.

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