16 Hours

| Wed Dec. 3, 2008 1:20 PM EST

16 HOURS....A new report has — once again — stated the obvious: it's insane to require doctors to work long shifts without sleep. And — once again — not everyone agrees:

The report, produced by the Institute of Medicine, an arm of the National Academies, recommended that medical residents ideally should work no longer than 16 consecutive hours, considerably less than the 30-hour shifts now allowed.

....Dr. Mark I. Langdorf, medical director of the emergency department at UC Irvine Medical Center and associate director of the residency program, called the recommendations "nuts."

"The problem here is balancing the need for patient safety, which I acknowledge, with the need to have the training in medicine be an apprenticeship," he said. "It sells the educational process short to make training so intermittent that you don't really get continuity."

"Continuity of care" has been the excuse for 30-hour shifts forever, but I've never seen a single person actually make a coherent case for objecting to a five-hour nap in the middle of a shift. They just chant continuity like a mantra and expect the rest of us to believe that 30 hours is some kind of talismanic number even though it really doesn't make any sense. Hell, I don't think I could even blog intelligibly after 30 hours, let alone make subtle and potentially life-saving diagnostic decisions. This may be an ancient practice, but so was bleeding patients until we figured out better. It's time to stop being idiots about this.

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