I have a family member that is a surgeon, and so is his wife actually. They are both young and both have lives that you cannot imagine. The wife, my sister in law, is already done with her residency and fellowship and at 34 can finally relax a bit. But they have 3 children and were working at one point 80 hours a week, my brother in law who is still a resident surgeon and about to start a fellowship is actually still working these hours and has 3 years left of this schedule. He has been victimized by the medical profession for nearly 10 years.
Meanwhile, people are dying everyday because of young residents who on average stay awake 30 hours during a shift and work up to 100 hours a week. And who is working the most hours? The newest residents who have the least experience.
Ms. Helen Haskell who lost her son to a situation like this has started a new organization called MAME (Mothers Against Medical Errors) as a way of coping with her loss and helping others avoid these volatile circumstances.
Doctors are most prone to errors from fatigue than they are inexperience, and the results can be a car crash, or a medical accident, and the personal cost can be even more savage. Depression is a prevalent side effect in young residents, and suicide rates are frighteningly high.
MAME and other organizations have been lobbying the ACGME which sets the parameters for resident training programs, to limit the sleep deprivation schedule imposed on residents to no more than 16 hours.
Activists are urging the Accreditation Council for Graduate Medical Education (ACGME), which controls medical residency training programs, to limit the amount of time residents go without sleep to 16 hours and to increase supervision of the residents. This would bring prevailing rules in line with recommendations outlined in a 2008 Institute of Medicine (IOM) report on resident duty hours.
The average shift for residents is 30 hours! The average work week is an unimaginable 90 hours. If there were a union in this industry there would have been a revolution years ago.
The NTSB which ensures safety in transportation has named fatigue as a significant contributing factor to the crash of a commuter jet in Buffalo. Of course in order to have any kind of perceptible change made the walking orders will probably need to come from Congress. And they are pretty busy right now screwing up health reform.
Residents have more than suicides to worry about though, traffic accident rates are so high amongst this group that one resident puts his car into park at every traffic light to avoid falling asleep at the wheel after an average shift.
“My body is not made to work 30 hours or more,” said Dr. Dan Henderson, health justice fellow with the American Medical Student Association. “If I’m truly going to do no harm as I pledged, I need a system to protect patients against errors caused by my fatigue. If ACGME isn’t willing to do the right thing hopefully consumers and lawmakers will be ready to step in.”
