Maximum work hours??

[coffeebythelake]

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For EM attendings, are there any particular regulations that would preclude one from working 80 hours a week? Everybody seems to talk about 12 12's per month, which only ends up at 36 hours a week.

 

[The Buff]

When I saw this topic on the main page I knew it had to be a medical student that posted it... Working 80 hours a week as an emergency physician is insanely tiring and not sustainable mentally or physically over any extended period of time.

Often my IM/surgery resident friends sort of look at me weird when I tell them that I don't work 80 hours a week in the ED. Trying to explain that when I am working I dont round leisurely, sit and slowly write notes for hours, or chill in the surger lounge like they do so our hours working are like apples and oranges does not seem to ever compute with them.

 

[anonymousEM]

Outside of extremely rural practices, most attendings work 8-12 hr shifts. I have occasionally worked 80 hrs in a week as an attending (7 12s in 7days) but it was in order to have several days off before or after that stretch of shifts. It's exhausting and every time I say I'll never do it again.

There are a few very rural EDs that look for coverage from Friday night to Monday morning type shifts. I suppose it is conceivable that you could work 80hr in a place like this for many weeks but you'd be living in the hospital in a tiny town. These practices are in places where you'd have no specialty backup and be the only doc in the ED.

 

[docB]

I don't know of any actual regulations limiting physician work hours in general or emergency physician hours in particular.

From a labor law standpoint we are exempt from most state overtime and hours regulations because we are graduate degree level professionals (assumed not to need protection by the law from predatory employers🙄) and/or because many of us are independent contractors.

From a safety standpoint overworking yourself will lead to errors. My feeling is that you can't effectively work a load of 2.5 patients per hour for more than 12 hours unless your paradigm is really unusual (eg. you have midlevels, scribes, discharge planners, admission coordinators, etc. working on every patient with you). If you're trying to do 24 or more you really need to have some protected sleep time, say 4+ hours in each 24 of uninterrupted sleep, to be of any use.

 

[EctopicFetus]

Outside of extremely rural practices, most attendings work 8-12 hr shifts. I have occasionally worked 80 hrs in a week as an attending (7 12s in 7days) but it was in order to have several days off before or after that stretch of shifts. It's exhausting and every time I say I'll never do it again.

There are a few very rural EDs that look for coverage from Friday night to Monday morning type shifts. I suppose it is conceivable that you could work 80hr in a place like this for many weeks but you'd be living in the hospital in a tiny town. These practices are in places where you'd have no specialty backup and be the only doc in the ED.

I moonlit at a place like this.I once pulled a 30 hour shift out there due to the oncoming doctor not being able to be there for a bit. Then being an idiot i scheduled myself to work a residency shift right after so I then literally drove to a 9 hour resident shift.

I basically worked 39 hours in a row. The moonlighting shifts were super easy and the place only averaged 15 patients a day. I luckily slept no less than 5 hours in a row except my last night there.

80 hours would be killer. Where I work now after 12 hours I am ready for bed.

 

[TysonCook]

I did ~84hrs/wk several times this fall (7 x 12hrs, + overage). I wanted to shoot myself in the face....repeatedly. It is NOT sustainable, nor safe.

 

[SoCuteMD]

Did this not happen to any of you in residency? I did it twice earlier this year and have another stretch of it later this spring. It sucks and it's not sustainable over the long term, but IMHO it's not nearly bad as the stupid 13 day stretch without a day off that you end up getting when you are q4 overnight off-service.

 

[turtle md]

I just worked 7 straight shifts (9 hours) and am now working another 7. But this was my choice so I could get a couple weeks off. While the time off was great, 7 in a row is brutal. I prefer not to work so much, as I want to spend time doing other things.

 

[TysonCook]

....Did this not happen to any of you in residency? I did it twice earlier this year and have another stretch of it later this spring....

Yes, but my private job is a seriously different level of crazy busy and stress 🙂

 

[Red Beard]

I always hear about the "12 12's," and used to think "36 hours a week....cake!"

At the place I rotated, however, I noticed the EPs would be "on" from 7 to 7, but would often either stay up to an hour late or show up to their next shift an hour early to finish charting, tying up loose ends, etc. And they often looked freaking WIPED when they would plop down at a computer to take care of this stuff.

Is that post-shift workload typical or atypical?

 

[Venko]

From my perspective its pretty typical, and may even underrepresent the non-shift duties. I know our attendings handle a lot of correspondence duties, research responsilities, quality improvement projects, and teaching responsibilities...

TL

 

[Radiohead]

This month, I worked 14 8's. Very relaxing. I would much rather work less and have time to be home with my family.

 

[Apollyon]

I don't know of any actual regulations limiting physician work hours in general or emergency physician hours in particular.

From a labor law standpoint we are exempt from most state overtime and hours regulations because we are graduate degree level professionals (assumed not to need protection by the law from predatory employers🙄) and/or because many of us are independent contractors.

From a safety standpoint overworking yourself will lead to errors. My feeling is that you can't effectively work a load of 2.5 patients per hour for more than 12 hours unless your paradigm is really unusual (eg. you have midlevels, scribes, discharge planners, admission coordinators, etc. working on every patient with you). If you're trying to do 24 or more you really need to have some protected sleep time, say 4+ hours in each 24 of uninterrupted sleep, to be of any use.

At the place I was formerly, it was limited by the department medical director to 12 hours a shift; there was one guy who would do a 14, but he cherry picked the patients and didn't set the world on fire (we wondered who he had pictures of, because he dictated his way, and got it). With a paradigm shift, another guy was working the same place with 16's (the back to back 8's), and it seemed to work, but, again, he took the "fast track" types.

 

[EvoDevo]

Did this not happen to any of you in residency? I did it twice earlier this year and have another stretch of it later this spring. It sucks and it's not sustainable over the long term, but IMHO it's not nearly bad as the stupid 13 day stretch without a day off that you end up getting when you are q4 overnight off-service.

Try 19 days. Oi.

 

[gutonc]

Try 19 days. Oi.

Those are painful. The longest stretch I've done as a resident was my first rotation, in the ICU as an intern. Day 1 of the rotation was my scheduled day off. I then worked 15 straight before getting another day off. Honestly, everything after that was cake.

 

[DrMom]

I did a run of 23 days in a row as an intern transitioning from surgery to peds. The good news was that I barely did any work on peds, although they still kept me there 12 hrs a day. Still sucked.