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It's really amazing how it's illegal to drive a truck without mandatory rest periods but it's not just allowed but expected that doctors will administer medical

It's really amazing how it's illegal to drive a truck without mandatory rest periods but it's not just allowed but expected that doctors will administer medical care under shiftwork conditions guaranteed to create extreme fatigue.

nradov 2y ago
It's a trade-off. I won't defend abusive working conditions or forced sleep deprivation. But research has shown that the risk of serious medical errors greatly increases when a hospitalized patient is handed off from one doctor to another. This is a real phenomenon which has been extensively studied. So, when doctors work long hours it does improve patient outcomes, up to a point.
- sibeliuss 2y ago
  Thank you for answering a long standing question of mine.
- mech987876 2y ago
  As far as I understand, the most common achievable choice is between staffing a hospital with 3 8 hour shifts per day or 2 1w hour shifts per day. Studies have shown the 12 hour shift system has better outcomes.
  - qazxcvbnmlp 2y ago
    There is a difference in human performance between working 3 or 4 12 hour shifts and 6/7 12 hour shifts a week.
- lurking_swe 2y ago
  how is this relevant though? One could conceive of a schedule where doctors and nurses work 12 hours shifts 3 days a week, and give them every other day off. Then nobody is sleep deprived and handoffs are reduced. Just hire double the doctors and nurses, this way there are no gaps in the work week! Logically this is a very obvious and simple solution. But there are a few problems. 1. doctors and nurses expect to be paid a lot of money. Especially doctors, because they go into a lot of debt to get their education. 2. there IS money in the system to hire double the amount of doctors and nurses, but there’s an artificial shortage of doctors 3. there are many administrators with their hand in the cookie jar. More money should go to the people working directly with patients. The status quo isn’t a good trade off. It’s probably the best outcome in our currently broken system though.
  - red-iron-pine 2y ago
    > how is this relevant though? most serious errors crop up during shift changes. nurses forget to check a box, or get distracted and leave something out, doctors don't do a follow up, etc. over millions of hospital hours across the US -- the 3rd most populous country in the world -- each shift change causes dozens of errors, and people sometimes die from that. increasing them to 12 or 24 hour shifts does increase the likelihood of fatigue-based poor decisions and errors, but at a lesser amount than shift change-related errors.
potato3732842 2y ago
That says more about the relative positions of doctors and truck drivers in society than it does about the relative hazards of the jobs.
- aleph_minus_one 2y ago
  > That says more about the relative positions of doctors and truck drivers in society than it does about the relative hazards of the jobs. Also about the availability of truck drivers and doctors: If - there is a constant demand for these services, - and people are willing to pay a sufficiently large amount for the services, - and the supply of qualified people to do the job is lower than the demand, the salaries will go up, but also the amount of work hours that are expected will increase.
  - jordanb 2y ago
    Rules apply to all transportation jobs: truck drivers, airplane pilots, railroad engineers, etc. The affect of fatigue on attention and decision making is very well studied.
deleted 2y ago
[deleted]

nradov 2y ago

It's a trade-off. I won't defend abusive working conditions or forced sleep deprivation. But research has shown that the risk of serious medical errors greatly increases when a hospitalized patient is handed off from one doctor to another. This is a real phenomenon which has been extensively studied. So, when doctors work long hours it does improve patient outcomes, up to a point.

sibeliuss 2y ago
Thank you for answering a long standing question of mine.
mech987876 2y ago
As far as I understand, the most common achievable choice is between staffing a hospital with 3 8 hour shifts per day or 2 1w hour shifts per day. Studies have shown the 12 hour shift system has better outcomes.
- qazxcvbnmlp 2y ago
  There is a difference in human performance between working 3 or 4 12 hour shifts and 6/7 12 hour shifts a week.
lurking_swe 2y ago
how is this relevant though? One could conceive of a schedule where doctors and nurses work 12 hours shifts 3 days a week, and give them every other day off. Then nobody is sleep deprived and handoffs are reduced. Just hire double the doctors and nurses, this way there are no gaps in the work week! Logically this is a very obvious and simple solution. But there are a few problems. 1. doctors and nurses expect to be paid a lot of money. Especially doctors, because they go into a lot of debt to get their education. 2. there IS money in the system to hire double the amount of doctors and nurses, but there’s an artificial shortage of doctors 3. there are many administrators with their hand in the cookie jar. More money should go to the people working directly with patients. The status quo isn’t a good trade off. It’s probably the best outcome in our currently broken system though.
- red-iron-pine 2y ago
  > how is this relevant though? most serious errors crop up during shift changes. nurses forget to check a box, or get distracted and leave something out, doctors don't do a follow up, etc. over millions of hospital hours across the US -- the 3rd most populous country in the world -- each shift change causes dozens of errors, and people sometimes die from that. increasing them to 12 or 24 hour shifts does increase the likelihood of fatigue-based poor decisions and errors, but at a lesser amount than shift change-related errors.

potato3732842 2y ago

That says more about the relative positions of doctors and truck drivers in society than it does about the relative hazards of the jobs.

aleph_minus_one 2y ago
> That says more about the relative positions of doctors and truck drivers in society than it does about the relative hazards of the jobs. Also about the availability of truck drivers and doctors: If - there is a constant demand for these services, - and people are willing to pay a sufficiently large amount for the services, - and the supply of qualified people to do the job is lower than the demand, the salaries will go up, but also the amount of work hours that are expected will increase.
- jordanb 2y ago
  Rules apply to all transportation jobs: truck drivers, airplane pilots, railroad engineers, etc. The affect of fatigue on attention and decision making is very well studied.

deleted 2y ago

[deleted]