New research on whether more hours leads to better care. healthcare
, “When I trained, good or bad, I worked about 120 hours a week. That was just expected. Today the average resident finishes with around 900 operative cases. I finished with twice as many.”
While physician sentiment toward long work hours has undoubtedly softened, many doctors, often those who trained in an era without restrictions on work hours, still question whether doctors today are trained as well as they used to be., my colleagues and I analyzed the outcomes of nearly 500,000 hospitalized patients in the U.S. who were treated by newly independent doctors with varying exposure to work-hour restrictions during their residency training.
To account for the fact that overall hospital care has improved over time, we used as a second control group doctors who completed residency 10 years earlier. We looked at the same three patient outcomes for these doctors, who were never exposed to work-hour restrictions during their residency training. Any trends in their patient outcomes over time should reflect only changes in the quality of hospital care, rather than any impact on care of having worked fewer hours during residency training.
Comparing doctors who completed their training before 2006 with those who completed theirs after it, 30-day mortality rates for hospitalized patients treated by first-year internists fell from 10.7% to 9.9%, a change that couldbe used to argue that working fewer hours in residency led to better-trained doctors. But a similar decline was observed for 10th-year internists, whose patient mortality rates fell from 11.2% to 10.4%.
Our findings relate to the current epidemic of burnout among physicians — more than 40% of U.S. physicians reported experiencing burnout
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