Dr. Pauline Chen (always worth a read in the New York Times) has a take on why the most recent ACGME work hour restrictions for residents have been largely a failure.
“Fatigue is bad, but overwork is worse,” said Dr. Lara Goitein, lead author of a recently published editorial in JAMA Internal Medicine and a pulmonary and critical care physician at Christus St. Vincent Regional Medical Center in Santa Fe, N.M.
Health care trends over the last two decades have only exacerbated young doctors’ workload. Admissions to teaching hospitals increased nearly 50 percent from 1990 to 2010; in that same period, the number of doctors in training available to do the work increased by only 10 percent. And because insurers are pushing for shorter hospital stays, only the sickest patients, many of whom require complex care, remain hospitalized.
Are residents nowadays really expected to do more than those decades ago even if they’re technically working less? Maybe the stories of those before me trekking up hill both ways in the snow to save lives are something else. Then again, I am finding time to write this blog post.