June 8th, 2016
A response to my original post on the dangers of physicians impaired by exhaustion was so troubling as to warrant promulgation because it reflects an opinion shared by many surgeons. A sincere surgeon suggested the following
"I appreciate the article and the concern for patient safety. Unfortunately the reality of the world is that there is a shortage of physicians and although many residents are being sheltered by protective limited call hours and other restrictions, these same protections are not afforded in practice. Often physicians/surgeons will take 4-5 day stretches of call which can be grueling and tiresome. As a resident we are trained to "suck it up" and ensure the highest level of healthcare is delivered. ... I almost feel bad for the new wave of surgical residents if the 80 hr work week is lifted, but until hospital administration or our medical societies have a way to deal with smaller surgical practices, I think it is essential for young surgeons to be prepared for the "real" world where they may have to take 4-5 days of call in a row."
The reality being described is profoundly disturbing. The suggestion is that outside the setting of training, physicians are even more sleep deprived and impaired therefore, more dangerous to their patients. The recommendation is to prepare surgeons for the real world by perpetuating the status quo. Teaching physicians to attempt to function while exhausted is like practicing drunk driving to improve your performance. If anyone suggested training airline pilots or operators of nuclear power plants to learn to do their jobs while exhausted, they would be ridiculed.
Our public health officials and institutions need to overtly reject this disquieting logic and regulate work hours in medicine as is done in every other industry where public welfare is at stake!
See original article, http://goo.gl/qBmbLg
Nicolas Argy, MD, JD