The Week Begins
Monday morning I start the week long ICU rotation. I will be on call one week night, Monday this time, and the weekend. Monday morning I start a work day that lasts until Tuesday at 4:30 pm. Saturday morning I start a call weekend that ends Monday at 4:30 pm. We recently recruited a new partner. During the interview process some of the candidates asked if you got the day after being on call off, to which we responded "In your dreams, that's where you have the day after call off."
Non-medical people often think this is crazy. How can you work for 36 to 48 hours, during which time you may or may not get any sleep. My first response is that I have been doing just that since I was in my early twenties, and it's the difference between a doctor and a civilian. Patients don't get sick at convenient times, and if you don't like staying up at night, working holidays, going without sleep for a day or two at a time, then find a different profession.
Residency training programs now have time limits on work periods and require that residents go home by 1 pm after being on call the night before. Basically, instead of doctors, modern residency programs are producing skilled laborers who work shifts. Upon finishing training they will be ready to go to work for health care corporations. We have seen this most clearly in the shift to hospitalists, who are employees of whichever corporation owns the hospital, and cover the inpatients and new admissions, working defined shifts of 6 to 8 hours. Although they are all well rested, patient care responsibilities turn over several times a day as shifts end and none of the doctors really gets to know a given patient well.
My view is that the one big advantage of being a doctor is that you don't have to work for anyone else, ever. As a highly educated and skilled professional, you can open your own practice, run your clinic however you see fit. I love that part of being a partner in a small private practice. I have no boss to impress, no supervisor who can judge me. My patients are the only ones I answer to, and my practice is based on a professional obligation to provide them the best care possible.
Non-medical people often think this is crazy. How can you work for 36 to 48 hours, during which time you may or may not get any sleep. My first response is that I have been doing just that since I was in my early twenties, and it's the difference between a doctor and a civilian. Patients don't get sick at convenient times, and if you don't like staying up at night, working holidays, going without sleep for a day or two at a time, then find a different profession.
Residency training programs now have time limits on work periods and require that residents go home by 1 pm after being on call the night before. Basically, instead of doctors, modern residency programs are producing skilled laborers who work shifts. Upon finishing training they will be ready to go to work for health care corporations. We have seen this most clearly in the shift to hospitalists, who are employees of whichever corporation owns the hospital, and cover the inpatients and new admissions, working defined shifts of 6 to 8 hours. Although they are all well rested, patient care responsibilities turn over several times a day as shifts end and none of the doctors really gets to know a given patient well.
My view is that the one big advantage of being a doctor is that you don't have to work for anyone else, ever. As a highly educated and skilled professional, you can open your own practice, run your clinic however you see fit. I love that part of being a partner in a small private practice. I have no boss to impress, no supervisor who can judge me. My patients are the only ones I answer to, and my practice is based on a professional obligation to provide them the best care possible.
posted by ICUDOC at 8:48 PM
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