Sunday, September 16, 2012

Whose patient is it anyway?

Spent another hour at our site's Medical Advisory Committee meeting on Friday which is essentially a circle jerk in which the doctors and the administration pretend that the doctors have anything to do with running the hospital.  At least breakfast was provided and wasn't too bad, although not quite up to the standards of some of our administrators.

Towards the end of the meeting an item came up where it seems that residents will only now be allowed to work 16 hours consecutively.  There was of course the usual concern about how we were going to run our hospital without all that cheep labour.  Then inevitably somebody  brought up the issue of if residents worked fewer hours, should not the length of their training be extended.

I had to respond to this.

"For the past 30 years," I said, "anaesthetic residents have not worked after being on call.  This means that the anaesthetic residency is about one year shorter than comparable residencies.  Yet if your life depended on being cared by:  a newly qualified surgeon, a newly qualified internist or a newly qualified anaesthesiologist, which specialty would you pick?"*

The answer is of course pretty obvious as most of the room acknowledged.  It is not quantity of training, it is quality of training.

What I should have asked, and might have asked if I hadn't had to leave to start working.

"How come hospitals with similar case loads to ours who have never had residents are able to deliver good patient care?"


"Don't you guys get paid to look after your patients?"

We of course don't get residents on a regular basis in anaesthesiology at our hospital.

* Obviously for this hypothetical question, different scenarios for each specialty are possible.

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