Millennials in medicine take healthier approach to work hours

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By Robert McCartney
Sunday, March 21, 2010

We learned last week that the older generation of doctors is looking down its nose at the new crop coming out of medical school because it's resisting working 30-hour shifts and 80-hour weeks in local hospitals.

Those young people. Such slackers. They've sure got a lot of nerve suggesting that maybe, just maybe, it's not in patients' best interest to be treated by physicians struggling to keep their eyelids up and their minds alert at the end of an all-nighter. What gall!

I'm a baby boomer, but my sympathies are entirely with the millennials on this one. In fact, I applaud them for pressing the medical establishment to reform work schedules that have violated common sense and ignored scientific research for decades.

Moreover, I think the millennials, those in their early 30s or younger, are trying to accomplish another goal that we boomers said was important to us when we were young -- and then mostly dropped. They want a healthier balance between work and personal life. They say that society's institutions, like hospitals, ought to find ways to offer that.

This boomer says: Right on.

The issue arose in a story in Thursday's Post by my colleague Ian Shapira. He reported that older physicians are worried that residents just out of medical school aren't getting enough hands-on training because national guidelines say they're supposed to work "only" 80 hours a week. The limit on individual shifts is for 24 consecutive hours of patient care, plus six for patient handoff and educational work.

The veterans expressed frustration that the new generation didn't want to learn medicine the same way they did in the 1970s and 1980s. That's when residents worked 36-hour shifts and 120-hour workweeks, rules that officially were changed in 2003.

The older folks should study some of the scientific literature on sleep deprivation. It establishes -- what a surprise! -- that people have trouble learning and remembering things when they've been up for 24 hours straight.

That means the veterans shouldn't wring their hands when residents go home rather than stay beyond their shifts to observe one more procedure. The youngsters' brains aren't in any shape to absorb the material, anyway.

"If you are deprived of sleep [for one night], your ability to actually learn new facts is significantly compromised by about 40 percent," said Matthew Walker, an assistant professor of psychology and neuroscience at the University of California at Berkley.

He added, tartly, "I don't know of any evidence that medical residents are immune to these effects." Walker has 10 years' experience in sleep research.

Then there's the risk to patients. There's abundant research showing that sleep-deprived doctors are more likely to make errors, including fatal ones.


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