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That was more or less my reaction as well. I could understand there being a few years of anomalous data as a result of small sample size, but to then boast of
by MereInterest 6y ago
That was more or less my reaction as well. I could understand there being a few years of anomalous data as a result of small sample size, but to then boast of it rather than taking it as a sign of very serious issues doubles down on a bad sign.
I agree that the 24-hour shifts are ridiculous. I could see some potential benefit for reducing the number of shift handoffs (e.g. 12-hour shifts expose patients to 2 shift changes per day, but 8-hour shifts expose patients to 3 shift changes per day), since shift handoffs have been shown to be the source of miscommunications. However, as your link points out, there is no decrease in standard of care resulting from removing 24-hour shifts, so that is not a reason to keep 24-hour shifts.
Also, thank you for the link on it, though the tone of that article was definitely odd. It took the lack of effect of shift duration on patient care as a reason to extend shifts back up to 24 hours, rather than concluding that there is no reason to keep shifts at 24 hours. Similarly, it takes as a given that after a 16-hour shift, you only get 8 hours off, rather than treating that as another sign of poor shift scheduling. (From the article, “When you’re on a 16-hour shift that ends Monday at 11 p.m., you still have to come back to the hospital on Tuesday at 7 a.m.,” she noted. “When you’re on a 24-hour shift, you leave on Tuesday at 7 a.m., and you don’t have to report back for duty until Wednesday. That is a better arrangement. You have the rest of the day to do things.”)
- waterhouse 6y ago> the tone of that article was definitely odd Yeah, I interpret it as self-serving propaganda and mendacity. I will assume the worst at every turn—for example, that the supportive quotes are cherry-picked; that they insert pictures of smiling doctors to try to make people think those opinions are normal; that they made certain that the dissenting doctor's opinion was described as "a minority opinion", and was immediately followed with "Dr. Mathis did acknowledge, however, that the ACGME change in requirements was here to stay"; that the "members of the AMA’s Resident and Fellow Section" they apparently polled were cherry-picked; that they asked several poll questions and chose to report the one with the most favorable result (and that "Do you think it's a good idea?" scored worse than "Do you think it's better than 16-hour shifts?"); that they reported it as "a majority" because it sounds higher than "52%"; et cetera. This is unfair, but I expect it's the best starting point for understanding. > Similarly, it takes as a given that after a 16-hour shift, you only get 8 hours off Yeah, it appears to be easier to work for an additional 8 hours and get the whole next day off, than to persuade those who choose the shifts to let you come in a couple of hours later on the day following a 16-hour shift.