Why Surgeons Struggle with Work-Hour Reforms
James E. Coverdill, John D. Mellinger
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Sozialwissenschaften, Recht, Wirtschaft / Sonstiges
Beschreibung
On July 1, 2003, work-hour reforms were enacted nationally for the roughly 129,000 resident physicians in the United States. The reforms limit weekly work hours (a maximum of eighty per week) and in-hospital call (no more than once every three nights), mandate days free of clinical and educational obligations (one day in seven), and regulate other aspects of resident work life.
Why Surgeons Struggle with Work-Hour Reforms focuses on general surgeons, a historically long-hour specialty, who fiercely opposed the reforms and are among the least compliant. Why do surgeons struggle with the reforms? Why do they continue to work long hours and view the act of doing so as reasonable if not quintessentially professional? Although the analysis is situated in the growing scientific literature on the consequences of fatigue, the authors do not adjudicate between the claims of surgeons and reform advocates about the effects of long work hours on patient or provider safety. Rather, the aim is to explore and explain how aspects of the occupational culture of surgeons and the social organization of surgical training and practice interlock to impede the reforms.
Kundenbewertungen
shift mentalities, gendered institutions, normative error, work hours, intuition, social structure, occupational culture, patient ownership, fatigue and performance, academic medicine, advanced practice providers, cross coverage, graduate medical education, night float, sleep science, sociology of work, surgeons, patient handoffs, social organization, professionalism, medical records, medical professionalism, clinical workloads, mixed methods, shift-length limits, operative notes, tacit knowledge, work-hour reform