{"id":8330,"date":"2017-03-14T22:36:28","date_gmt":"2017-03-15T02:36:28","guid":{"rendered":"http:\/\/blogs.nejm.org\/hiv-id-observations\/?p=8330"},"modified":"2017-03-15T12:41:16","modified_gmt":"2017-03-15T16:41:16","slug":"poll-allow-24-hour-shifts-interns","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/poll-allow-24-hour-shifts-interns\/2017\/03\/14\/","title":{"rendered":"Poll:  Should We Allow 24-Hour Shifts Again For Interns?"},"content":{"rendered":"<p><a href=\"http:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2017\/03\/ferret.jpeg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignright size-medium wp-image-8331\" src=\"http:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2017\/03\/ferret-300x193.jpeg\" alt=\"\" width=\"300\" height=\"193\" srcset=\"https:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2017\/03\/ferret-300x193.jpeg 300w, https:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2017\/03\/ferret-768x493.jpeg 768w, https:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2017\/03\/ferret.jpeg 800w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a>Over on Boston&#8217;s\u00a0NPR site, I <a href=\"http:\/\/www.wbur.org\/commonhealth\/2017\/03\/13\/opinion-interns-28-hour-shifts\" target=\"_blank\">wrote a piece<\/a> about the decision by the Accreditation Council for Graduate Medical Education (ACGME) to allow 24 hour (or longer) work shifts again for interns.<\/p>\n<p>My goal in writing the piece was to relay what I experienced doing these long shifts way back when during my internship &#8212; the good and the bad.<\/p>\n<p>Not surprisingly, most of the comments\u00a0I&#8217;ve received from non-MDs are highly skeptical that there could be\u00a0<em>anything<\/em>\u00a0good about working such a long\u00a0shift. And if you listen to\u00a0the linked radio segment on the site, you can\u00a0sense the incredulousness of the hosts, neither of them doctors. Their tone is practically dripping with, &#8220;You&#8217;ve got to be kidding me.&#8221;<\/p>\n<p>From my friends and colleagues in medicine, however, what I wrote seems to have resonated &#8212; here are a few of the emails I received:<\/p>\n<blockquote><p>&#8220;Great piece on 28 hour shifts! \u00a0Wonderful description of our days as interns. Forwarded to my daughter who is in her third year of med school.&#8221;<\/p>\n<p>&#8220;Paul, I loved reading your piece. I had the same set of experiences and thought you captured the highs and lows perfectly. Thanks!&#8221;<\/p>\n<p>&#8220;GREAT piece\u2026I wish I could call you &#8216;old&#8217; [ahem] but, alas, that was me in that description of internship too.&#8221;<\/p>\n<p>&#8220;Your article \u2013 truly wise and wonderful, by far the best treatment of such a complicated topic that I have read, ever (I crossed out <em>in years<\/em>).&#8221;<\/p>\n<p>&#8220;<span class=\"UFICommentBody\">Spot on, Paul! We learned the cycle of illness, both to recovery or to progression of disease. And, we were the patient&#8217;s doctor from day one.&#8221;<\/span><\/p><\/blockquote>\n<p>I don&#8217;t cite those just to toot my horn (obviously that&#8217;s a little bit of it), but also to emphasize that\u00a0this experience we had with long shifts wasn&#8217;t exclusively terrible. <em>Some<\/em> good came out of it as well.<\/p>\n<p>But did these positives actually outweigh the very substantial negatives, which I also outlined in that piece? I just don&#8217;t know, and hence\u00a0am not sure if the ACGME should be applauded for allowing more flexibility in training, or &#8212; and this is the mainstream view &#8212; should they be criticized for bringing back work shifts that put patient safety in jeopardy?<\/p>\n<p>Since I&#8217;m now back with this readership, I&#8217;m dying to know what you think. Based on the <em>NEJM Journal Watch<\/em> sophisticated reader metrics, you are predominantly practicing clinicians &#8212; doctors, nurses, PAs. And we also know that 22% of you have dogs, 14% cats, 6% both, and 0.0412% have ferrets. (Yuck.)<\/p>\n<p>Please <a href=\"http:\/\/www.wbur.org\/commonhealth\/2017\/03\/13\/opinion-interns-28-hour-shifts\" target=\"_blank\">read the piece<\/a>, vote in the poll below, and feel free to provide your comment or comments. We&#8217;ll stratify the results by pet ownership.<\/p>\n<p>Thank you.<\/p>\n<div id=\"polls-42\" class=\"wp-polls\">\n\t<form id=\"polls_form_42\" class=\"wp-polls-form\" action=\"\/index.php\" method=\"post\">\n\t\t<p style=\"display: none;\"><input type=\"hidden\" id=\"poll_42_nonce\" name=\"wp-polls-nonce\" value=\"f508167d87\" \/><\/p>\n\t\t<p style=\"display: none;\"><input type=\"hidden\" name=\"poll_id\" value=\"42\" \/><\/p>\n\t\t<p style=\"text-align: center;\"><strong>Should interns be allowed to work 24-hour shifts?<\/strong><\/p><div id=\"polls-42-ans\" class=\"wp-polls-ans\"><ul class=\"wp-polls-ul\">\n\t\t<li><input type=\"radio\" id=\"poll-answer-132\" name=\"poll_42\" value=\"132\" \/> <label for=\"poll-answer-132\">Yes -- it improves continuity of care, and studies don't show that shorter shifts improve safety.<\/label><\/li>\n\t\t<li><input type=\"radio\" id=\"poll-answer-133\" name=\"poll_42\" value=\"133\" \/> <label for=\"poll-answer-133\">No -- fatigue increases medical errors, and long shifts are bad for the interns, too.<\/label><\/li>\n\t\t<\/ul><p style=\"text-align: center;\"><input type=\"button\" name=\"vote\" value=\"   Vote   \" class=\"Buttons\" onclick=\"poll_vote(42);\" \/><\/p><p style=\"text-align: center;\"><a href=\"#ViewPollResults\" onclick=\"poll_result(42); return false;\" title=\"View Results Of This Poll\">View Results<\/a><\/p><\/div>\n\t<\/form>\n<\/div>\n\n<p><a href=\"https:\/\/secure.jwatch.org\/registerm?cpc=JWATCH&amp;promo=OJFOBLOG&amp;step=1\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2017\/03\/hivJWAd540x250.jpg\" alt=\"Register Now for more NEJM Journal Watch Content\" width=\"540\" height=\"250\" class=\"aligncenter size-full wp-image-925\" \/><\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Over on Boston&#8217;s\u00a0NPR site, I wrote a piece about the decision by the Accreditation Council for Graduate Medical Education (ACGME) to allow 24 hour (or longer) work shifts again for interns. My goal in writing the piece was to relay what I experienced doing these long shifts way back when during my internship &#8212; the [&hellip;]<\/p>\n","protected":false},"author":6,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3,6,8,9],"tags":[1151,595],"class_list":["post-8330","post","type-post","status-publish","format-standard","hentry","category-health-care","category-medical-education","category-patient-care","category-policy","tag-internship","tag-medical-education-2"],"post_mailing_queue_ids":[],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/8330","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/comments?post=8330"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/8330\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/media?parent=8330"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/categories?post=8330"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/tags?post=8330"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}