The arguments are being played out and the patients are the ones who will not benefit. Not that the doctors or residents (in training) will fare that much better, but the biggest loser may be the hospitals. They may force both doctors and residents out as they try to keep costs down in that area while raising daily charges for ICU rooms and supplies used in ICUs. Plus hospitals seem to be encouraging doctors to over prescribe medications when patients are dismissed from ICUs.
Now that the Supreme Court has spoken on residents hours and the OSHA is about to make other rules into regulations, if hospitals do not hire more doctors for handling patients in the ICU, the hospitals will lose doctors and patients and may not be able to recover from the downward spiral. Not only will people not trust the ICU but doctors will not want to work there and patients may start requesting to be taken to other hospitals.
That is what is causing the headlines like the article that got me on this topic. Yes, I agree attending physicians are probably putting in far too many hours to the detriment of the ICU patients. But really, where does the fault lie. Doctors are human and start making mistakes after working too many hours. Again, why are they working these long hours?
It is because the hospitals have restricted the number of doctors in ICU. All the studies done will not convince me otherwise. Also most of the physicians are blaming the curtailing of resident hours (or interns) for the problems of working more hours themselves. I realize that the physicians are not going to bad-mouth the source of their pay check, but someday they may be forced into this by rules and regulations.
Hospitals need to realize that if they don't adequately staff ICUs and other places, lawsuits may soon be directed at them and not the physicians. This seems presently to be a no win situation for patients in ICUs. This needs to end.
Read the Medscape article here.
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