Editore"s Note
Tilting at Windmills

Email Newsletter icon, E-mail Newsletter icon, Email List icon, E-mail List icon Sign up for Free News & Updates

January 15, 2005
By: Kevin Drum

ASLEEP AT THE SCALPEL....A couple of days ago I posted about a new study that confirmed the startling news that medical interns who have been awake for 30 straight hours probably aren't functioning at full capacity. However, I'm afraid some of you might not have taken this problem sufficiently seriously. So at least for the men in my audience I'm afraid I have to do something to get your attention. Here's the testimony of medical student Jonathan Dworkin over at Aspasia:

In New York City residents routinely begin their day at six or seven in the morning, work twelve hours, then stay on call all night. In a practice that I think is particularly cruel, they typically don't get home until noon the following day several hours after morning rounds. During this extended time they perform simple tasks, like circumcisions. That's right, circumcisions. During my clerkship in Elmhurst Hospital, Queens, I noticed that many of the OB interns would do the deed post call. The man behind the guillotine is the same man that hasn't slept since last Tuesday. And you wonder why there's some funny looking penises out there?

Yuck. But it did get your attention, didn't it?

On a more serious note, Jonathan quotes the following from a 2000 journal article defending the traditional practice of forcing interns to work until their brains turn to jelly:

There is little evidence to support the claim that sleep deprivation is a serious cause of medical misadventures. Nevertheless, the changes in house officers' working hours and responsibilities have profound implications. Changes in the time allotted to teaching, the ability to learn from patients admitted after a shift is over, and the increasing loss of continuity, all may have a negative impact on physician training. It is not clear that trainees are being realistically prepared for the actual practice of medicine physicians often work extended hours.

The most serious concern that has been raised is the loss of professionalism by physicians. Residents are now viewing themselves as hourly workers, and the State has intervened in an area of training formerly left to the profession to manage. We are now training doctors in New York State who will be comfortable working in an hourly wage setting, but not in the traditional practice of medicine as it has been in the United States during this century. We are concerned that this may sever the bond between doctor and patient a bond that has been the bedrock of our conception of a physician.

The most remarkable thing about this is how obviously lame it is I think "transparent bullshit" is the term Jonathan uses. It's like listening to five year old trying to invent an explanation for why he put the cat in the washing machine. It doesn't stand up to even a moment's scrutiny.

Just something to keep in mind when you're deciding whether to have your kid circumcised. Caveat emptor.

Kevin Drum 12:57 AM Permalink | Trackbacks

Bookmark and Share
 
Comments




 

 

Read Jonathan Rowe remembrance and articles
Email Newsletter icon, E-mail Newsletter icon, Email List icon, E-mail List icon Sign up for Free News & Updates

Advertise in WM



buy from Amazon and
support the Monthly