4 ms·

i mean, reading the article would give you several reasons why they didn't think avoiding fatigue was a good tradeoff.

by princeb 10y ago

cauterized 10y ago
I see one in the article, which is wanting a single doctor to consistently be available through a course of treatment. But I don't see how 24 hours guarantees that any more than 16. I for one would rather my doctor worked 8 hours, went to bed for 8, and returned for the third (or 4th) 8 hours than that they be on their feet trying to keep their eyes open for 24 hours straight and remember everything that I and 20 other patients have said to them or undergone in the last 24 hours. Would you rather have your surgeon hand the scalpel off to another doctor, or have them proceed while so fatigued as to be drunk? And in case you didn't notice, the article also points out the dangers of fatigue, just with the journalistic integrity that suppresses the expression of the outrage that those of us who aren't journalists should all be responding with.
- chimeracoder 10y ago
  > I for one would rather my doctor worked 8 hours, went to bed for 8, and returned for the third (or 4th) 8 hours than that they be on their feet trying to keep their eyes open for 24 hours straight and remember everything that I and 20 other patients have said to them or undergone in the last 24 hours. According to empirical research, that is actually more dangerous for you, because the handoff points are most likely to introduce errors. It's counterintuitive, but that's something that both providers and peer-reviewed medical journals agree on.
wwweston 10y ago
I only see one -- a personal continuity of care argument ("Patients want to know 'you are the doctor taking care of them,' Kothari says."). If that's true, I think it's kind of fascinating. I'd certainly like to know that there is someone who is taking enough interest in me as a patient that they consider themselves ultimately accountable for providing or coordinating a professional standard of care. But I don't need that person to be the personal face of that care all the time, and frankly, it's ridiculous to assert the system behaves that way now. And I definitely want to know that person is operating without cognitive impairments, and definitely don't think "continuity" means "one person." I'm sure there's realities of actually doing the work that I don't understand, and I also know that handing off information and coordinating people is far from trivial (I know that we're really not all that good at it in software, a profession where for anything to work at all you have to pass around carefully encoded instructions). I just don't understand the given argument. Also, I see at least one professional counterargument in the article.
- AnkhMorporkian 10y ago
  As someone who got out of the hospital recently after a couple weeks in, I see the continuity of care argument. I had a lot of doctors in my time there, and the left hand really didn't know what the right hand was doing. I spent an extra 4 days in because one of my doctors thought the other doctor was going to write the discharge order, and vice versa.

i mean, reading the article would give you several reasons why they didn't think avoiding fatigue was a good tradeoff.

by princeb 10y ago

i mean, reading the article would give you several reasons why they didn't think avoiding fatigue was a good tradeoff.

I see one in the article, which is wanting a single doctor to consistently be available through a course of treatment. But I don't see how 24 hours guarantees that any more than 16. I for one would rather my doctor worked 8 hours, went to bed for 8, and returned for the third (or 4th) 8 hours than that they be on their feet trying to keep their eyes open for 24 hours straight and remember everything that I and 20 other patients have said to them or undergone in the last 24 hours. Would you rather have your surgeon hand the scalpel off to another doctor, or have them proceed while so fatigued as to be drunk? And in case you didn't notice, the article also points out the dangers of fatigue, just with the journalistic integrity that suppresses the expression of the outrage that those of us who aren't journalists should all be responding with.

chimeracoder 10y ago
> I for one would rather my doctor worked 8 hours, went to bed for 8, and returned for the third (or 4th) 8 hours than that they be on their feet trying to keep their eyes open for 24 hours straight and remember everything that I and 20 other patients have said to them or undergone in the last 24 hours. According to empirical research, that is actually more dangerous for you, because the handoff points are most likely to introduce errors. It's counterintuitive, but that's something that both providers and peer-reviewed medical journals agree on.

wwweston 10y ago

I only see one -- a personal continuity of care argument ("Patients want to know 'you are the doctor taking care of them,' Kothari says."). If that's true, I think it's kind of fascinating. I'd certainly like to know that there is someone who is taking enough interest in me as a patient that they consider themselves ultimately accountable for providing or coordinating a professional standard of care. But I don't need that person to be the personal face of that care all the time, and frankly, it's ridiculous to assert the system behaves that way now. And I definitely want to know that person is operating without cognitive impairments, and definitely don't think "continuity" means "one person." I'm sure there's realities of actually doing the work that I don't understand, and I also know that handing off information and coordinating people is far from trivial (I know that we're really not all that good at it in software, a profession where for anything to work at all you have to pass around carefully encoded instructions). I just don't understand the given argument. Also, I see at least one professional counterargument in the article.

AnkhMorporkian 10y ago
As someone who got out of the hospital recently after a couple weeks in, I see the continuity of care argument. I had a lot of doctors in my time there, and the left hand really didn't know what the right hand was doing. I spent an extra 4 days in because one of my doctors thought the other doctor was going to write the discharge order, and vice versa.