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What's really bad is that the American medical establishment, including these doctors, seem to be defending this practice. It'd be really interesting to see a

by Arizhel 10y ago

What's really bad is that the American medical establishment, including these doctors, seem to be defending this practice. It'd be really interesting to see a good study comparing the rate of medical errors and resultant patient deaths/injuries in hospitals in the US and in other industrialized nations, and to also compare the hours worked between them. Another thing that came up in the article is the problem of hand-over between doctors and medical teams, and that having ridiculously-long hours seems to be a patch to avoid all the problems that come from that. That sounds like an organizational and procedural problem: doctors and nurses aren't properly writing things down, or if they are, they're not writing them in a legible way. I had a recent experience where I had to accompany a friend on an ER trip. Different doctors and nurses kept asking her, over and over throughout the lengthy visit, what she was there for, and to describe the symptoms. It was eerie; there seemed to be absolutely no information recording and usage by these people, it was like everything was all-new every time some new person came on the scene. It was also really strange how they kept telling her totally different and contradictory things: one nurse says she's not allowed to have any food or water (despite being parched), another nurse says this is wrong, etc. (She ended up drinking water out of the bathroom sink because she was so thirsty, and was there for a possible cardiac problem so electrolyte depletion certainly can't help.) American ERs seem to be very scary, incompetently-run places.

JshWright 10y ago
As a paramedic, I understand your frustration with answering the same questions repeatedly. There is absolutely information being recorded and tracked, and it's very likely the provider walking into the room has already read the notes written by those who were there earlier. However, much like debugging a technical problem, a systemic approach is necessary for patient assessment. Everyone has their process which they have developed over the years... The pattern and flow to their questions, the order in which they assess various body systems, etc. Jumping around in that process to cover the handful of questions they couldn't find the answers to in earlier reports is a recipe for skipping something. I'm not saying there isn't room for improvement here. My wife recently spent two months in the hospital, and there were several times where we had to 'educate' a provider about what the plan was (i.e. we would discuss something with the attending, but they didn't chart it well, so the senior resident wasn't up to speed on the changes, etc...)., however, when it comes to those assessment questions being asked repeatedly, there is a method to that particular madness.
pmarreck 10y ago
> is that the American medical establishment, including these doctors, seem to be defending this practice. Yeah, and hazing is a pattern passed down from generation to generation, like childhood beatings /onlypartialsarcasm

by Arizhel 10y ago

JshWright 10y ago

As a paramedic, I understand your frustration with answering the same questions repeatedly. There is absolutely information being recorded and tracked, and it's very likely the provider walking into the room has already read the notes written by those who were there earlier. However, much like debugging a technical problem, a systemic approach is necessary for patient assessment. Everyone has their process which they have developed over the years... The pattern and flow to their questions, the order in which they assess various body systems, etc. Jumping around in that process to cover the handful of questions they couldn't find the answers to in earlier reports is a recipe for skipping something. I'm not saying there isn't room for improvement here. My wife recently spent two months in the hospital, and there were several times where we had to 'educate' a provider about what the plan was (i.e. we would discuss something with the attending, but they didn't chart it well, so the senior resident wasn't up to speed on the changes, etc...)., however, when it comes to those assessment questions being asked repeatedly, there is a method to that particular madness.

pmarreck 10y ago

> is that the American medical establishment, including these doctors, seem to be defending this practice. Yeah, and hazing is a pattern passed down from generation to generation, like childhood beatings /onlypartialsarcasm