According to an article in today’s Chicago Tribune, medical residents[medical school graduates caring for patients under the guidance of more experienced physicians] are still working way too many hours. The article, written by Mary Engel, discusses a report released Tuesday by the Institute of Medicine, an arm of the National Academies. The report recommends that residents not be allowed to work more than 16 consecutive hours. Currently, residents are permitted to work, get this, 30 hour shifts. And they are required to work those grueling hours despite a number of recent studies that have shown that that residents who work too long without sleep are, suprise, suprise, more likely to injure themselves or patients.
There are however, those who disagree with shortening the 30 hour shifts. Mark Langdorf, MD, Medical Director of the Emergency Department at the University of California Irvine Medical Center, is one of those who disagrees. In fact, he categorized the new recommendation as “nuts”. Langdorf claims that any advantage gained by shorter shifts[like doctor and patient safety]would be outweighed by the disadvantage of having to turn patients over to doctors who don’t know the patient’s history. I’m no doctor, but I have to disagree with Langdorf. I thought the standard of care required that when any patient is turned over to another doctor, a comprehensive oral history is given to the new doc by the departing doctor. In addition, the patient’s chart is presumably available, as is the nursing staff who typically has more contact with the patient anyway. And frankly, how sharp is a resident going to be after an exhausting 30 hour shift? I’m not sure I want some recent med school graduate making critical decisions about my health on Thursday morning, when he hasn’t slept since Tuesday night. Hopefully these reforms will be enacted.