4 ms·

My understanding is that at least at one point in the past the AMA lobbied either for the cap or to not fix the problem. Also inversely speaking, you don't real

by whaleofatw2022 3y ago

My understanding is that at least at one point in the past the AMA lobbied either for the cap or to not fix the problem. Also inversely speaking, you don't really hear much about the AMA lobbying to -fix- the problem and given the frequency of this theory, you would think they would publicise it more. There is also the weird thing where, my understanding is that the hospitals can 'sell' the slots to each other and strangely they can fetch more than the funding in question. But really, so much of the medical residency industrial complex reminds me of a hazing ritual in and of itself.

303uru 3y ago
>reminds me of a hazing ritual in and of itself It's absolutely abusive and I cannot believe there's never been more of a push around patient advocacy. It's bad enough for the residents working 100 hours a week and getting fits of sleep in a shitty spare hospital room they share with multiple other residents. It's even worse for the patients receiving care from a tired, overworked resident.
- phren0logy 3y ago
  There has been a push back, and hours are now capped well below 100 hours (maybe 60 hours a week now?) with limits on duration of shifts, also. When I trained the cap was 80 hours/week with a limit of 30 hours in a row.
  - 303uru 3y ago
    Where? I still see/hear of residents in the states working 80+. Many pulling 20-24 hours a day for 3 or more days a week, then additional coverage beyond that.
  - cpburns2009 3y ago
    The cap is still 80 hours/week. I'm not sure about the consecutive hour limit. It's at least 24 hours. That doesn't stop the residents I know from frequently having duty hour violations. In one case I know a resident had his hours manipulated by admin to under report them.
  - SkyPuncher 3y ago
    There is theoretically a cap, but my wife (a doctor) knows many peers who either: * Been made clear in no uncertain terms (mafia style) that they were never to log more than the regulated hours, regardless of actual hours worked. * Weird things started to happen if they did log more than the required hours.
- mindslight 3y ago
  And yet in my few experiences, the residents are actually the ones that will talk to you and tell you what is going on. As opposed to the super important Attendings who you only see when it's time to talk about things with legal repercussions like pulling the plug.
downrightmike 3y ago
The program was started by a guy hopped up on cocaine the whole time, that's why the hours alone suck: "William Stewart Halsted developed a novel residency training program at Johns Hopkins Hospital that, with some modifications, became the model for surgical and medical residency training in North America. While performing anesthesia research early in his career, Halsted became addicted to cocaine and morphine" https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7828946/#:~:text=William%20Stewart%20Halsted%20developed%20a,addicted%20to%20cocaine%20and%20morphine https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7828946/#:~:tex....

303uru 3y ago

>reminds me of a hazing ritual in and of itself It's absolutely abusive and I cannot believe there's never been more of a push around patient advocacy. It's bad enough for the residents working 100 hours a week and getting fits of sleep in a shitty spare hospital room they share with multiple other residents. It's even worse for the patients receiving care from a tired, overworked resident.

phren0logy 3y ago
There has been a push back, and hours are now capped well below 100 hours (maybe 60 hours a week now?) with limits on duration of shifts, also. When I trained the cap was 80 hours/week with a limit of 30 hours in a row.
- 303uru 3y ago
  Where? I still see/hear of residents in the states working 80+. Many pulling 20-24 hours a day for 3 or more days a week, then additional coverage beyond that.
- cpburns2009 3y ago
  The cap is still 80 hours/week. I'm not sure about the consecutive hour limit. It's at least 24 hours. That doesn't stop the residents I know from frequently having duty hour violations. In one case I know a resident had his hours manipulated by admin to under report them.
- SkyPuncher 3y ago
  There is theoretically a cap, but my wife (a doctor) knows many peers who either: * Been made clear in no uncertain terms (mafia style) that they were never to log more than the regulated hours, regardless of actual hours worked. * Weird things started to happen if they did log more than the required hours.
mindslight 3y ago
And yet in my few experiences, the residents are actually the ones that will talk to you and tell you what is going on. As opposed to the super important Attendings who you only see when it's time to talk about things with legal repercussions like pulling the plug.

downrightmike 3y ago

The program was started by a guy hopped up on cocaine the whole time, that's why the hours alone suck: "William Stewart Halsted developed a novel residency training program at Johns Hopkins Hospital that, with some modifications, became the model for surgical and medical residency training in North America. While performing anesthesia research early in his career, Halsted became addicted to cocaine and morphine" https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7828946/#:~:text=William%20Stewart%20Halsted%20developed%20a,addicted%20to%20cocaine%20and%20morphine https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7828946/#:~:tex....