There’s been a lot of talk about the work hours of resident physicians. Given that sleep deprivation has been shown to impair various aspects of human performance, it certainly seems reasonable to limit the level of “resident impairment”. But we have surprisingly little data to work from. And, for better or worse, physicians post-residency don’t have much of a choice when it comes to work hours.
My wife often remarks on how I’m able to answer a page out of a deep sleep, give orders, and go back to sleep. Upon morning review, these orders do, in fact, make sense. It was my training that allowed me to be able to function this way, and it’s a damned good thing. I’m not arguing that residents should be worked into the ground like in the good old days. We must take into account the impairment that lack of sleep may cause, but we must also recognize that learning to think and act under a variety of conditions is important. Also, patient continuity of care is important, and the more that a patient is “handed off” from team to team, the less likely any one doctor is to take responsibility for that patient.
But that’s not really what I meant to write about. Let me give you an a glimpse of doctoring in real life.
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