Health Care Bill Passed...more hours?

[Macguy86]

with the new healthcare bill about to passed in minutes..
32 million more people insured= more frequent visits to hospitals, ect essentially shocking the healthcare field.

does this mean as future interns, subspecialist fellows there will be more hours in the hospital. There is a 80 hr work week limit, some programs push that especially intern year, but does it mean more work for the residents/interns/fellows? Rather than have an intense intern year with slightly less hours PGY2,3,ect...to having ridiculous schedules for all of residency.

this sucks, specifically for categoricals it comes with a lower pay.

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[pinipig523]

with the new healthcare bill about to passed in minutes..
32 million more people insured= more frequent visits to hospitals, ect essentially shocking the healthcare field.

does this mean as future interns, subspecialist fellows there will be more hours in the hospital. There is a 80 hr work week limit, some programs push that especially intern year, but does it mean more work for the residents/interns/fellows? Rather than have an intense intern year with slightly less hours PGY2,3,ect...to having ridiculous schedules for all of residency.

this sucks, specifically for categoricals it comes with a lower pay.

Who cares if you work more during residency?!

That's what it's supposed to be, it's never meant to be a cakewalk.

The golden question is: when you graduate residency, will you be able to pay your student loans that you DIDN'T HAVE economic hardship to help you out which means you've gone into forbearance for all your time in residency thereby adding a large chunk into your principal?

The silver question would also be: If you have to go into forbearance for your loans, can you muster the balls to go into a fellowship knowing that your loans will nearly DOUBLE in that time AND do you know if you can find a job that will pay you enough to live comfortably after all the hard work you put in?

That's Obamacare for you.

 

[jdh71]

ACGME is pushing for a 56 hr work week and that has nothing to do with Obama-care.

 

[FutureDocDO]

Yeah, coming from an EM resident. You sure work hard.

Who cares if you work more during residency?!

That's what it's supposed to be, it's never meant to be a cakewalk.

The golden question is: when you graduate residency, will you be able to pay your student loans that you DIDN'T HAVE economic hardship to help you out which means you've gone into forbearance for all your time in residency thereby adding a large chunk into your principal?

The silver question would also be: If you have to go into forbearance for your loans, can you muster the balls to go into a fellowship knowing that your loans will nearly DOUBLE in that time AND do you know if you can find a job that will pay you enough to live comfortably after all the hard work you put in?

That's Obamacare for you.

 

[tacrum43]

It it time to "complete the great unfinished business of our society." Health care "is a right and not a privilege," she said.

Well said Madam Speaker.

Okay, so I'm a bleeding heart primary care type, but *finally* the U.S. gets on board (more or less) with the rest of the industrialized world. I really think this will help improve the overall health of our nation which, for the average patient, is the most expensive in the world but definitely not the best in outcomes.

However, I have no idea how will affect work hours/ patient load.

 

[pinipig523]

Yeah, coming from an EM resident. You sure work hard.

I've done your floor work, it's cake. You may put in the hours, but if you're IM - you've got a lot of free time during the day. The only time you put in actual work is call days, otherwise it's cake.

So don't tell me I don't work hard. I don't see you in the Trauma unit pushing patients to the hallway and escorting them into the CT unit. You don't see 20 patients in 1 shift, and you sure as heck don't have to handle resus patients like we do.

We (you and I) don't put the hours in like surg residents do, they get the most props for handling the load.

IM residents? Don't complain. You may work more hours than we do, but I guarantee you that our hours are harder. I don't even get a lunch.

When I was on the floor, I ate breakfast/lunch/and dinner. We still had time for grand rounds in the am, resident rounds for lunch, and team teaching in the pm. And still, I had time to surf the internet once my floor work was over until it was time to sign out to the night covering team.

 

[dreamfox]

I've done your floor work, it's cake. You may put in the hours, but if you're IM - you've got a lot of free time during the day. The only time you put in actual work is call days, otherwise it's cake.

So don't tell me I don't work hard. I don't see you in the Trauma unit pushing patients to the hallway and escorting them into the CT unit. You don't see 20 patients in 1 shift, and you sure as heck don't have to handle resus patients like we do.

We (you and I) don't put the hours in like surg residents do, they get the most props for handling the load.

IM residents? Don't complain. You may work more hours than we do, but I guarantee you that our hours are harder. I don't even get a lunch.

When I was on the floor, I ate breakfast/lunch/and dinner. We still had time for grand rounds in the am, resident rounds for lunch, and team teaching in the pm. And still, I had time to surf the internet once my floor work was over until it was time to sign out to the night covering team.

umm, i'm not really sure what program you were on the floors at; but that's not reality. bad place to start a debate between em and im.

 

[tncekm]

ACGME is pushing for a 56 hr work week and that has nothing to do with Obama-care.

8hrs/day 7 days a week (8x7=56)? If so, that sounds ridiculously stupid. *sigh*

I keep hearing that we need to limit hand-offs, so why not 15hrs/day, 4 days a week? 2 days on, 2 days off or something like that. We'd keep well rested and limit hand-offs.

 

[pinipig523]

umm, i'm not really sure what program you were on the floors at; but that's not reality. bad place to start a debate between em and im.

I did 6 months of floor work at a place that looks just like the picture painted by Obamacare. I've worked at a private hospital as well and it's the same. The only place that was really malignant was at Rush - floors were tougher, but still very manageable.

 

[jdh71]

8hrs/day 7 days a week (8x7=56)? If so, that sounds ridiculously stupid. *sigh*

I keep hearing that we need to limit hand-offs, so why not 15hrs/day, 4 days a week? 2 days on, 2 days off or something like that. We'd keep well rested and limit hand-offs.

The gossip is they don't even have a single MD on their "rules" comittee . . . this I cannot coroborate

 

[jdh71]

It it time to "complete the great unfinished business of our society." Health care "is a right and not a privilege," she said.

Well said Madam Speaker.

I'm sorry, but no one has "right" to be healthy. You may argue under equal protection every has a right to access and every does, ask our EM colleague posting in here about patient access.

Okay, so I'm a bleeding heart primary care type, but *finally* the U.S. gets on board (more or less) with the rest of the industrialized world. I really think this will help improve the overall health of our nation which, for the average patient, is the most expensive in the world but definitely not the best in outcomes.

Except there's no money to pay for any of it. This is another boondogle, only this time the insurance companies are getting the "bailout". I'm glad we could again use the democratic process to give billions of dollars, through force of the gun, to private, for profit companies

However, I have no idea how will affect work hours/ patient load.

This is simple economic. Supply and demand. What do you think is going to happen to that equation when it becomes "cheaper" for certain cohorts to get medical care? Then figure out how the increase in demand will affect supply. The I would notice that supply is currently limited and if you want to provide the supply for that demand, how do you think it going to happen outside of a limited supply doing MORE work?

 

[GoLytely]

It's absolutely great whenever I hear a service WHICH NEEDS TO BE PROVIDED BY SOMEBODY ELSE referred to as a "natural right." How exactly does this work? What about the rights of the providers to not be shackled into public servitude? Isn't this the same basic concept as slavery?

 

[tncekm]

The gossip is they don't even have a single MD on their "rules" comittee . . . this I cannot coroborate

That would explain a lot, and is ENTIRELY believable. :sad:

 

[FutureDocDO]

Please surgery residents work hard? The only hard thing about surgery is the hours and the Q3 calls. IM is harder than ER because of the hours. I'm not saying IM residents work harder than ER residents... it's the hours and the calls that make it hard.

I'd rather work hard 8-10hrs a day and not have calls or working 12+ hrs a day.

I've done your floor work, it's cake. You may put in the hours, but if you're IM - you've got a lot of free time during the day. The only time you put in actual work is call days, otherwise it's cake.

So don't tell me I don't work hard. I don't see you in the Trauma unit pushing patients to the hallway and escorting them into the CT unit. You don't see 20 patients in 1 shift, and you sure as heck don't have to handle resus patients like we do.

We (you and I) don't put the hours in like surg residents do, they get the most props for handling the load.

IM residents? Don't complain. You may work more hours than we do, but I guarantee you that our hours are harder. I don't even get a lunch.

When I was on the floor, I ate breakfast/lunch/and dinner. We still had time for grand rounds in the am, resident rounds for lunch, and team teaching in the pm. And still, I had time to surf the internet once my floor work was over until it was time to sign out to the night covering team.

 

[NotAProgDirector]

ACGME is pushing for a 56 hr work week and that has nothing to do with Obama-care.

The gossip is they don't even have a single MD on their "rules" comittee . . . this I cannot coroborate

Both of these are crazy.

Tom Nasca (MD) has come to speak to APDIM at the last several meetings. He's on the committee looking at duty hours. The committee is made mostly of physicians from different fields. He mentioned at the last meeting that there was widespread agreement that the new rules would keep the 80 hour limit. IN fact, he suggested that there would be flexibility based upon training level -- this might actually allow higher PGY levels to go above 80 (something surgical programs are looking for -- more hours for their surgical chiefs). Regardless, the 56 hour limit was a rumor and is not real.

...at least, that's what they say. The rules should be out this summer, so we'll see.

 

[mauvespice]

Both of these are crazy.

Tom Nasca (MD) has come to speak to APDIM at the last several meetings. He's on the committee looking at duty hours. The committee is made mostly of physicians from different fields. He mentioned at the last meeting that there was widespread agreement that the new rules would keep the 80 hour limit. IN fact, he suggested that there would be flexibility based upon training level -- this might actually allow higher PGY levels to go above 80 (something surgical programs are looking for -- more hours for their surgical chiefs). Regardless, the 56 hour limit was a rumor and is not real.

...at least, that's what they say. The rules should be out this summer, so we'll see.

Thanks, good to know. How about the napping break? I find myself groggier on post-call rounds if I have napped for 1-2 hours rather than without. I wonder if it even helps physiologically.

 

[jdh71]

Both of these are crazy.

Tom Nasca (MD) has come to speak to APDIM at the last several meetings. He's on the committee looking at duty hours. The committee is made mostly of physicians from different fields. He mentioned at the last meeting that there was widespread agreement that the new rules would keep the 80 hour limit. IN fact, he suggested that there would be flexibility based upon training level -- this might actually allow higher PGY levels to go above 80 (something surgical programs are looking for -- more hours for their surgical chiefs). Regardless, the 56 hour limit was a rumor and is not real.

...at least, that's what they say. The rules should be out this summer, so we'll see.

Thank God! (or the FSM if you prefer )

When I was told this gossip I was flabbergasted. Thanks for clearing it up.

EDIT: I guess that what I deserve for listening to a surgeon

 

[pinipig523]

I'd rather work hard 8-10hrs a day and not have calls or working 12+ hrs a day.

I can agree to that.