There comes a point where demanding "evidence" for something is more a means to dismiss an argument than to express a genuine academic interest. We don't need randomized, blinded, placebo-controlled studies to describe the obviously detrimental effects of repeated 100+ hour workweeks. Evidence is great, but demanding studies to describe the obvious is counterproductive.
Article for reference.
Well... in this area I think you do need more study; if only to better define the parameters.
The problem with much of the debate over work hours is that we don't know if we're really fixing the underlying problem.
Argument A) residents are overworked and because of lack of sleep they are making mistakes
Argument B) residents are undertrained and because of lack of knowledge they are making mistakes
Argument C) residents are overworked and because of lack of sleep they aren't learning as much and are making mistakes
Argument D) ... and so on and so forth
So which is it? The endpoint the laypublic cares about is medical errors. There has been a lot of debate over what really causes those. With a multifactorial problem like this it's hard to point to one change and say "this will make things better". There have been studies that show that lack of sleep makes one impaired. But it's still hard to say, based on those studies that it was the lack of sleep that directly caused the problems. Plus in some studies, even shortening the work day didn't translate to increased sleep because residents went home and did other things.
So I would argue that yes, more study is needed. This isn't one of the "obvious" areas of medicine. There are enough confounders in play that getting a handle on the problem is difficult.
Textbookversion said:
This is a hilarious post. Soldiers are a bunch of scared 19-21 year olds without any better prospects. Not magical heroes.
While I get what (I think) you're going for, that's kind of a tactless way to say it.
Perhaps it would be better to say something like... despite current public consensus, soldiers are not heroes just by virtue of doing their job. To give all soldiers automatic hero status upon enlistment/commission brings down the standards of "hero" and makes it more difficult to identify the ones who truly go above and beyond. Many 19-21yr olds joined as they saw this as the best (or only) avenue towards a career or a way to support themselves. Most didn't do it out of a selfless desire to help their country and protect their fellow Americans; they did it for the same reasons everyone else gets a job- to pay bills, provide for their family, and further their career goals.
Is the 19yr old supply tech who has never left a base in Louisiana any more of a hero just because they wear the uniform than say... a 6th grade math teacher in NYC? or a post office clerk in Tulsa? Calling all soldiers heroes is something we do to make ourselves feel good and show support. We're trying as a nation not to repeat the mistakes of post-Vietnam and condem all of the soliders just because they served in the military. Now the pendulum has swung the other direction, and although it's better on this side than the other, we are still over-heroizing people just by virtue of the employer they work for. I think you can be proud of someone and supportive of them, without having to elevate them to a status normally reserved for the exemplary outlier.
Mind you, I'm writing this while wearing body armor in my tent in Afghanistan. My belt has a stethoscope holster right next to my 9mm.
