One more night to go ...

Oh my oh my. Last night I went to sleep saying "After tonight, only more night before JB is home every night." I will be so happy to have him home.

JB was able to call me last night and actually talk for about five minutes as it wa a little slower. He also gave me the good news that it looks like (all things with his schedule are prefaced with this statement) he is not going to have to go Pensacola this Monday! The reason is that he has "his" clinic on Monday morning and then he has some session that is mandatory each week for all residents. It's a time that they can discuss any concerns or questions with others. This means that if he does his clinic and then this session, it will be lunchtime so it doesn't look like they are having him drive to Pensacola. YAY! This means that we will have Saturday night, Sunday, and Monday evening together. I am so excited about this. I am seriously, near tears with this news. I cannot wait to have some time with my husband. This morning he will be home even later than usual as he has an oral exam once he is done with the rotation.

Some of you have asked me why doctors must work these insane hours. I should tell you that as many mistakes that are made by physicians who are tired, the same amount of mistakes are made when there is limited "continuity of care". Think about, if you go to a hospital and stay there for 24 hours, do you want to have 3 different physicians (8 hours shifts)? Or would you like to have 1 physician (24 hour shift) or 2 physicians (12 hour shifts.) The more times a patient is "handed off" the more chance there is for mistake. Therefore not switching physicians so often is also beneficial to patients.

What is even more remarkable is that the requirement that residents only work "on average" 80 hours per week, is a recent development. Prior to that, there really were no rules. Since residents are "cheap" and not paid even a fraction of what a staff physician is paid, it makes sense financially to utilize their cheap labor. As a result, residents were working hours which were beyond reasonable. If you want to read a fantastic book on this topic check out Hot Lights, Cold Steel. It's a fantastic read but demonstrates how many hours it is possible for people to work.

So a few years ago all this changed. The Accreditation Council for Graduate Medical Education (ACGME) limited the number of work-hours to:

• 80 hours weekly
• Overnight call frequency to no more than one overnight every third day
• 30 hour maximum straight shift
• 10 hours off between shifts.

While these limits are voluntary, adherence has been mandated for the purposes of accreditation. In other words, failure to follow means a program will lose accreditation which is very, very bad.

Anyways, I say all that to say that the work hours do seem inhumane, and reading all the fellow residents blogs, you wonder if they are fair, but in the end, there are reasons why physicians stay at the hospital for such periods. At least that's what I keep telling myself.