Shortened trainee doctor hours no danger to patients
A medical student need not spend 100-hour work weeks to know their art. A new US study found no significant difference in patient safety or costs when comparing results from doctors trained before and after the caps of 80 hours of duties per week – reassuring to both doctors and patients.
The researchers analysed data from over 400,000 hospitalisations of Medicare patients – each case was assigned to a key doctor who dealt most with a patient, using billing codes. When cases were compared from two six-year time periods before and after 2006 – the first new doctors who were fully affected by the reforms had finished their residencies, to veteran doctors with 10 years’ experience,who trained under the old rules – there was no difference in patient deaths, read missions or costs.
Interestingly, patients seemed to depend on hospital teams, not just one doctor, and that may explain why doctor training time seemed to have no effect on care.
Teamwork and technology have changed hospital care so much that the impact of any one doctor is muted, according to lead author Dr. Anupam Jena of Harvard Medical School, Massachusetts. More changes are anticipated with the advent of artificial intelligence in diagnosis and treatment, but these apply to the training of internal medicine doctors only, not surgeons.
The President of the American Medical Student Association, Dr. Isaiah Cochran,supports keeping the 80-hour cap and other measures aimed at adequate sleep for doctors. Dr. Cochran, who worked 75 hours weekly during his last year of medical school at Dayton Children’s Hospital, Ohio, thinks the measure is doable.
Dr. Karl Bilimoria of Northwestern University Feinberg School of Medicine, Illinois, adds that there are better ways to train residents. He suggests eliminating extra paperwork and some academic conferences for residents, while adding nurse practitioners to the workforce may make training more efficient.
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