It's been 16 days since John had a day off, and his last day off capped a 13 day streak. This time last year, when the new ACGME regulations kicked in, wasn't nearly as crazy. Go figure. Anyway, I'm going to try posting about residency without being derailed by sarcasm or invective. (Must...not...drop...F-Bomb....)
Doc Russia commented below about how hospitals benefit from squeezing residents for all they're worth, rather than hiring physician's assistants. (I've posted about this myself, with facts and figures here). I was wondering if, as a medical student, he has been exploited more since the regulations limiting residents' hours have gone into effect. This reminded me of something awful that happened about 5 years ago, and how it took a potential fatality to stop egregious exploitation of medical students.
My husband went to medical school in New York, where the Bell Commission laws have limited residents to 80 hours per week since 1989. Enforcement was spotty statewide until about 1998, but was generally good at that hospital. Unfortunately, some departments (especially OB and Vascular Surgery), deprived of cheap resident labor, started exploiting medical students instead hiring PAs or nurse practitioners.
An exhausted medical student removed sutures from a patient much too early, causing a massive bleed. Fortunately, the patient recovered. But the rumors started flying: the medical student in question was at the top of the class, should have known better, and therefore must have done it deliberately to draw attention to the abuse perpetrated by the vascular surgeons. I refuse to believe this; it's almost too horrifying to contemplate. But an environment so toxic that such rumors can flourish is almost as disturbing as the incident itself.
In the aftermath, the Vascular Surgery Department hired 3 PAs to do their scutwork. My guess is that their combined salaries totalled about $200,000 per year. To belabor my point, residents (and medical students) are cheap labor for hospitals. I would be less angry about the whole situation if the Powers That Be would just admit it. It's hard to buy the argument that "it's about training" when inadequately supervised residents or students (cheap and free labor, respectively) are endangering vulnerable patients. How very convenient that this training regimen is good for the hospital's bottom line.
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