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For New Doctors, Eight Minutes Per Patient

Fri, 05/31/2013 - 9:50am
Pauline Chen, M.D.

At a social gathering not long ago, a colleague and I exchanged stories about residency training, fondly remembering the patients who had helped us grow both as doctors and as people.

A doctor-in-training we both knew listened intently to our conversation, but when we asked him about his experiences with patients, he looked lost and struggled for a response.

“My generation is different from yours,” he finally said, and then told us about getting “caught” sneaking back to the hospital earlier that year to talk with a couple of patients. He had already officially signed out for the night, but even going back just to say hello would count toward and push him over his 80-hour weekly work limit. Such a violation could cause his residency program to lose its accreditation.

“My generation is different because we can’t have the same relationships with patients as you did,” the young man said. “We just don’t have the time.”

His comment unnerved me then and for a long time afterward. I knew he was being honest about his own experiences, but I couldn’t believe that the same held true for all doctors-in-training. After all, most people I knew became doctors because they wanted to interact with patients.

Now a new study confirms what the young doctor told us: doctors-in-training are spending less time with patients than ever before.

How interns and residents spend their time has been of interest to academic researchers for more than 50 years, but in the late 1980s, as training programs came under increasing pressure to limit the work hours of young doctors, one study in particular raised concerns. The researchers trailed 15 doctors-in-training over five nights and found that residents spent only about 20 percent of their time with patients, with the bulk of their nights at the hospital devoted to paperwork, tasks that did not have to be done by a doctor like drawing blood and inserting intravenous catheters, and frequently interrupted attempts at sleep.

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