By Dan Henderson
If long shifts and weeks harm doctors and their patients, why keep them? Why does the ACGME need to be pushed in the first place? I think it’s instructive to look at the culture of medical education, and at what we as trainees are taught to value. Medical education is deeply rooted in tradition and hierarchy. We’re taught to do as was done before us, and to do what we’re told.
Reflecting on my own experience long hours, I was at first enthusiastic for the chance to sacrifice for my patients, to prove my mettle, to distinguish myself. Third year students are commonly told to “show up first and leave last” as a way to shine on their rotations. I used to be proud of the long hours I put in. Now, I’m ashamed. I’m embarrassed to have embraced such an out-of-date notion, one that could have harmed my patients. It’s time to recognize that when we set the bar for commitment to patients impossibly high, we lose sight of our larger purpose – healing them. The belief that each patient should have only one doctor is as anachronistic as bloodletting, and those who cling to long hours as the hallmark of professionalism are, to me, just like those on the wrong side of the debates over germ theory and antisepsis.