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Work Hours: Part 3 & Final

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 I’m embarrassed to have embraced such an out-of-date notion, one that could have harmed my patients.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.

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Comments  4

  • jessie 02 Aug

    Well, I guess the the long shifts and weeks are needed in the whole system!!
  • Paul, PA 20 Mar

    Dan, you are so right on! I entered the medical world to make a difference, and I've seen how paperwork and bureaucracy have bogged down the system. Technology (medical records) are making things easier to stomach, but at times, I too, think about opening my own specialty practice. There is no shortage of medical jobs out there, but finding a hospital that's a good fit for me and in a location my family can live with is tough.

    Paul, Loma Linda CA
  • adokadrik 04 Jun

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  • addyalver 06 Jun

    Greetings I recently finished reading through your blog and I'm very impressed. I do have a couple questions for you personally however. Do you think you're thinking about doing a follow-up posting about this? Will you be going to keep bringing up-to-date as well.
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