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Why Long Hours Are Good For Young Docs

Dr. Joseph Sirven
Dr. Joseph Sirven
Dr. Joseph Sirven

One of the last things you want at the hospital is a tired doctor. The American medical system has made changes to the amount of time a young doctor can be at work. But as KJZZ Commentator Dr. Joe Sirven tells us, long hours are an important part of the job.

Good night, good day, good morning!  I have no idea what time it is.  I’ve been awake all night supervising new doctors.  It's that time of year when newly graduated medical students begin a rite of passage - being on call in the hospital.

I started nighttime call duty in 1990.  Back then, being on-call was kind of like medical boot camp every other night. As much as I hated it, I learned to make life or death decisions under pressure. But everything changed after the daughter of a powerful New York Times journalist died due to mistakes blamed on a tired, unsupervised intern.  After an extensive investigation, the government limited on-call shifts to 30 hours straight and demanded an 80-hour workweek for student doctors. This will be further reduced in upcoming years.  So now, trainees’ work schedules are protected and theoretically so are their patients.

Despite all of my years of practice, decisions can get fuzzy when you’re tired. After a midnight phone call from the hospital, I often stare at the ceiling and wonder if I made any sense. I’ll always remember getting a call at 2:00 a.m. from a resident who needed my help.  I mumbled something and this plucky guy told me that he would give me five minutes to get myself together and then he'd call me again for a better answer.  That angered me so much that it cleared my mind. I thanked him the next morning.

So here’s my problem: Reducing on-call hours creates a system that isn't realistic for new doctors. Once they're out in the real world, there are no laws that limit their time. The work is grueling and stressful. You and I both know that most medical problems don’t happen between regular office hours. How do I tell these young doctors that it doesn’t get much easier after medical school?

Well, I guess I just did.

Dr. Sirven is a neurologist at the Mayo Clinic in Scottsdale.