Why are doctors so overworked?

[zbruinz]

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Why are residents forced into 80 hour weeks? In another country, doctors (including surgeons) only work about 40 hour weeks during internship and residency.

Why are doctors here so overworked?

 

[DrBowtie]

Cheap Labor.

 

[zbruinz]

is it necessary to treat doctors as cheap labor?

What is the average hours per week for a doctor out of residency? (assume IM)

 

[SoCuteMD]

"cause we're workaholics.

Let's all admit it...

 

[beary]

"cause we're workaholics.

Let's all admit it...

I'm not.

 

[Mayhem]

"cause we're workaholics.

Let's all admit it...

Yeah I'll admit it. I don't know about the rest of you but I can tell you: nobody lied to me when I applied. I knew full well I would spend many sleepless nights doing this and that i'd be exhausted for years at a time. And still I fought to do this. So I can't really say I'm being "forced" into 80 hour weeks. I chose to do this. I'm a workaholic...or a masochist. Both really.

 

[UCSBMed1]

Why are residents forced into 80 hour weeks? In another country, doctors (including surgeons) only work about 40 hour weeks during internship and residency.

Why are doctors here so overworked?

Its a symbiotic relationship:

The hospital needs a multitude of doctors to see their patients, but it would be impossibly expensive to use licensed, fully trained physicians solely.

The new medical school graduate needs post-graduate training in order to solidify and build on the knowledge he/she gained while in school.

Therefore the hospital hires new docs (residents) to staff their hospitals, but pay them crap because they don't know much and aren't fully accredited. The resident takes said crappy job because he/she needs the training, and the hours are necessary (some say we need even more than 80) to get the breadth and repetition of cases needed to become a competent physician. Does that help?

 

[zbruinz]

Ah, the process seems so demanding...

 

[Tanner5]

Ah, the process seems so demanding...

It isn't easy being a pimp.

 

[zbruinz]

It isn't easy being a pimp.

Or being pimped for that matter! 😀

 

[glp]

Why are residents forced into 80 hour weeks? In another country, doctors (including surgeons) only work about 40 hour weeks during internship and residency.

Why are doctors here so overworked?

i dont really think this is being overworked. anyone who wants to make 6 figures and more works these hours at some point in his/her life. not just physicians but business/law types as well. 80 hrs is pretty cake compared to the hours some those people keep.

 

[RobHan]

someone has to do the "dirty" work 😛, given the strictly controlled # of accepted med students each yr, this country is facing a serious physician deficiency. each yr there are about 30% residency positions matched to IMGs i think.

and isn't it used to be even more than 80hrs/week? an article on time said that some physicians don't like the new 80hrs/w rule (suckers, haha) cause they think the mistakes caused by more frequent shift changes are even more than those caused by exhausted residents

i also feel puzzled by the system, how come we have to wait for 10 hrs in each ER visit?

Why are residents forced into 80 hour weeks? In another country, doctors (including surgeons) only work about 40 hour weeks during internship and residency.

Why are doctors here so overworked?

 

[angel80]

Residents used to work in excess of 100 hours a week in some fields (Surgery, IM, etc) prior to these new ACGME regulations put into effect a few years ago, so the 80 hours is a nice change for many. I am extremely grateful for it. Although it is impossible to learn everything during residency, residents need to have enough training to make them competant physicians. If the work week hours are decreased even more to 60 hours, like some people are advocating, then extra years will have to be added to each residency. I would rather do 3 years of residency with an 80 hour work week than 4 years with a 60 hour work week. By the way, I don't know how it is in all European countries, but in the UK, you can get stuck in the position that is the equivalent of a Resident in the US for 10 or more years sometimes (they don't promote you to attending until another attending dies or retires, so you could be stuck for years waiting for that to happen). I would never trade our system for theirs.

 

[CANES2006]

i also feel puzzled by the system, how come we have to wait for 10 hrs in each ER visit?

backup of patients

 

[DW3843]

i also feel puzzled by the system, how come we have to wait for 10 hrs in each ER visit?

You have to wait so damn long because the ER stands for Emergency Room, but somehow most people tend to forget that. Therefore, you will find nearly every ER across the country stacked full of people waiting to get checked out for a headache or some lame "cold." Then you have the psychotic parents who bring their kids in everytime they cough or sneeze. Next, you get to deal with the repeat customers: the drunks, the drug users, the drug seekers, and the homeless.

Meanwhile, the ER doctor is busy working up some 60 yo man with an acute MI or trying to keep an MVA victim from dying in the trauma bay.

That is the reason for the wait. Half (or more) of the people in the waiting room do not need to be there. They should, instead, be waiting for their appointment with their primary care physician, or better yet heading over to CVS to get some NyQuil.


On a related note, you should check out this thread from the EM forum. It is absolutely hilarious and had me laughing out loud for days:
http://forums.studentdoctor.net/showthread.php?t=257985

-- sorry to hijack this thread --

 

[njbmd]

Why are residents forced into 80 hour weeks? In another country, doctors (including surgeons) only work about 40 hour weeks during internship and residency.

Why are doctors here so overworked?

Hi there,
Most residents outside of the surgical specialties do not work 80 hours per week unless they are in very malignant programs. In the surgical specialties, most programs have gone to a system to get hours down to 80 hours.

The 80-hour work week may be wonderful for residency but at an attending, you may end up well over 80 hours. Of course, there are plenty of jobs that you can get that will drop you back to 40-60 hours. After all, no one breaks your arm and forces you into medicine.

njbmd 🙂

 

[Seagal]

Hi there,
Most residents outside of the surgical specialties do not work 80 hours per week unless they are in very malignant programs. In the surgical specialties, most programs have gone to a system to get hours down to 80 hours.

The 80-hour work week may be wonderful for residency but at an attending, you may end up well over 80 hours. Of course, there are plenty of jobs that you can get that will drop you back to 40-60 hours. After all, no one breaks your arm and forces you into medicine.

njbmd 🙂

Question for Njbmd--
What is a 80 hr work week? Seven days a week about 12 hours each?

 

[zbruinz]

I think it's four 12 hour shifts, one 36 hour shift and one day off.

I'm not sure about this.

 

[8744]

i dont really think this is being overworked. anyone who wants to make 6 figures and more works these hours at some point in his/her life. not just physicians but business/law types as well. 80 hrs is pretty cake compared to the hours some those people keep.

True. I went through periods as an engineer when I worked like a dog. But I was getting paid and I was doing meaningful work. Same with when I was a Marine where the necessity to both train for and conduct combat operations dictated the tempo.

On the other hand a lot of what you will do in residency is utterly pointless, low-grade clerical work that is hardly worth losing sleep over.

 

[Smurfette]

Question for Njbmd--
What is a 80 hr work week? Seven days a week about 12 hours each?

80 hours can be divided any number of ways. The actual rule is 80 hours a week averaged over 4 weeks, or 320 hours a month.

My weekdays are generally 12-14 hours long on average. If I'm on call, I do 30ish hours over 2 days. The number of calls I have a week varies from 1-3. On weekends, if not on call, I work until I get everything done I need to and then leave (2 hours, 4-5 hours [usual], 10 hours, whatever it takes). If I'm on call on the weekend, I'll go over my hours for the week...but usually I will have a different weekend completely off, and maybe work 1 day each of the other 2 weekends so it averages out. Then I get my required 4 days off over 4 weeks. However, this varies SIGNIFICANTLY by what service I am rotating on, and in general this varies by the type of residency it is (IM vs. Surgery vs. FP...etc.). Some services use the night float system, in which some residents only work the night shift so that the "day" resident only take overnight call on days not covered by night float.

You'll see how different services do it when you start hospital rotations....

 

[humuhumu]

Check out this thread: Does residency NEED to be so bad?

 

[dajimmers]

The real reason doctors work so much? PAs and RNs secretly lobby for MDs to have to work a lot, so the MDs are too tired to lobby for themselves. In this way, the PAs and RNs can steal the money-making bits of the medical profession (surgery, prescriptions, etc.). And since only the graduates of the top medical schools can get into the low-workload "lifestyle" residencies, most doctors are stuck in this vicious cycle.


😉

 

[Blade28]

That is the reason for the wait. Half (or more) of the people in the waiting room do not need to be there. They should, instead, be waiting for their appointment with their primary care physician, or better yet heading over to CVS to get some NyQuil.

Good post.

At the county hospital here, many of the patients don't have a PCP - they just come to the ER for all their medical needs. That creates a horrible backup in the ER waiting room.