Tuesday, September 08, 2009

Tired doctors

Patients dying at the hands of doctors working for days on end | The Courier-Mail

Public hospital doctors in Queensland certainly got a lot of publicity yesterday about their long work hours and the mistakes they are leading to. Even though this is all part of a pay and conditions campaign, I doubt there is much reason to doubt the stories of overwork and its dangerous consequences.

On talkback radio, and in comments in the paper, many people make a pretty valid comparison: we have tight laws to try to prevent long distance truck drivers from falling asleep on the job, yet there is no equivalent for hospitals, despite the life and death nature of what they routinely do.

Part of the issue with junior doctors and long hours seems to have been a reluctance of older doctors, who had it tough when they were an intern, to agree that young doctors should have better conditions. And in fact, in the comments in the Courier Mail following the story, there is still evidence of a "suck it up" attitude:
I am actually a doctor at one of the large hospitals in Brisbane and it has been blown out of proportion all this safe hours rubbish. I have not worked over 60 hours in a week for more then 5 years. Most of the doctors are complaining that they do not work enough because they now don't get enough experience. Going to see a senior doctor is not goign to be as safe in a few years time becasue instead of seeing hundreds of different cases on a specific illness he will have only seen 20 or 30 because of all these safe hours hysteria. There are a few exceptions to the rule but in the majority junior docotrs don't get enough experience anymore.... I am sure if you check those doctors records who make the mistakes I have a feeling you would see they probably make mistakes if they are tired or not....
I suspect "Joan" is a crusty old nurse offering her support to that anonymous doctor:
I agree with the doctor in comment 99. Most of the junior doctors are gone by 5pm - regardless of what is happening medically with their patients.The really long shifts disappeared a generation ago - and now those doctors ( as the senior consultants) are actually the ones filling in the gaps left by the "safe hours" campaigners amongst the junior doctors. Without enough experience these junior doctors will never reach the same level of skill that more senior doctors achieved during their early training years. Maybe the problem is that since medicine became a post graduate degree, the young enthusiastic junior doctors have been replaced by older more militant ones. Maybe the current junior doctors can't function under stress - which surely should be a prerequisite in their job.
In a few subsequent comments, many doctors dispute Joan's account of what a breeze the hours now are.

Of course, having more doctors in the system would help too.

1 comment:

Geoff said...

...and now they are just being told to drink more coffee - as if they haven't been already.

This nonsense about learning more by working longer hours is just ridiculous, except in the sense that learn from your mistakes and you make more mistakes when you are tired.

You learn more if you are given more real work to do and in city hospitals often the interns are doing a lot of form filling in but little medicine. Then they are suddenly pushed into roles where they need expertise they have not been taught.

It does seem from the comments you quoted that having doctors graduating in their mid to late twenties rather than much younger has meant that they are less likely to be cowed into copping the nonsense sweet.

Doctors should perhaps work the same hours as the beaurocrats who employ them.

(Disclaimer - I am a doctor and I did work these ridiculous hours in the remote past)