Would you trust your life and well-being to a doctor who was at the end of a 24-hour work shift?
In Summer 2017, new rules start that allow hospitals to keep doctors-in-training working for 24 hours straight
Do you think that patients at major academic hospitals in a large medical center consistently get top-notch, cutting-edge health care?
Would you be surprised to learn that, at times, young doctors a year or two out of medical school are handling patient care with little in-person supervision from seasoned, more experienced doctors?
In the Houston area, there are a lot of big hospitals in the Texas Medical Center that advertise or are viewed as offering a higher standard of care in medicine. And, to be sure, many of the top-level doctors who practice at these hospitals are involved in cutting-edge research and develop breakthrough treatments. Think about hospitals like Memorial Hermann Texas Medical Center, Children’s Memorial Hermann, Texas Children’s Hospital, Houston Methodist Hospital, Baylor St. Luke’s Medical Center, and M.D. Anderson Cancer Center.
All of these hospitals are teaching hospitals. This means that attending physicians, who are fully trained and more experienced, are teaching resident doctors, fresh out of medical school and still in training, how to practice medicine. And this apprentice-style system uses real-live patients as their guinea pigs, so to speak.
To be clear, we all have to learn our jobs, and I am not trying to insult or demean doctors who are still in training. As a society, we really need them. My concern for patient safety is with the hospital administration and attending doctors who overload the resident doctors. Let me explain why.
As a Texas medical malpractice lawyer, I have handled many cases where my clients were treated in major teaching hospitals and were the victims of medical errors at the hands of inexperienced resident doctors who were not being supervised in-person by fully-trained doctors.
Quite often, resident physicians are tasked to work shifts that experienced doctors do not want—nights, weekends, and holidays. Add to that the fact that they are overworked and fatigued. It is a recipe for errors and mistakes, and it is about to get worse.
In March 2017, the group that sets standards for U.S. medical school residents voted to eliminate a 16-hour cap on a work shift for first-year residents, the young doctors just out of medical school. The Accreditation Council for Graduate Medical Education new rule, which will go in effect this summer, will allow hospitals to force residents to work up to 24 hours straight. The new rule will apply to over 120,000 doctors in training.
This all makes me think about a stroke case that I recently handled against Houston Methodist Hospital, an academic hospital that is home to the nation’s first comprehensive stroke center. My client came into the emergency room with textbook stroke symptoms that were misdiagnosed by a resident doctor just a year and a half out of medical school. It was a weekend evening, when the fully-trained doctors were not in the hospital, so the resident spoke with his attending doctor from the stroke team over the phone. Sadly, my client was discharged and suffered from a large stroke.
I am not saying that my client’s case was directly related to the number of hours that the resident had been working, because I do not know for sure. I do expect, though, to see more cases like this when resident doctors are working up to 24 hours straight, and treating patients when their supervising doctors are not in the hospital.
What you can do
Let’s say that you have to go to a hospital on a weekend or holiday, then keep in mind if you choose a major teaching hospital, most of your in-person health care may likely be provided by doctors who are still in training. You may consider choosing a hospital that is not located in a major medical center, or in a suburb, because at those locations fully-trained doctors will likely be on duty.
If you find yourself in a teaching hospital, you can always ask what role the resident doctors will play in your care. A good time to ask this question is when going over the consent forms. Under some circumstances, it may make sense to withhold consent for care by residents. That means that only fully-trained experts will be seeing you.
In other situations, if a resident is treating you or your family member and you are not confident in the diagnosis, treatment, or discharge decision, then tell the resident or nurse that you want to be seen in-person by an attending physician in whatever specialty is necessary.
If you or someone you care for has been injured as a result of poor care provided by a resident that was not properly supervised, then call 281-580-8800 for a free consultation with the medical malpractice attorneys at Painter Law Firm.
Robert Painter is a medical malpractice lawyer at Painter Law Firm PLLC.
On 4/1/2018, the new law will end the current practice where doctors can secretly enter a DNR order against patient and family wishes [...]read more
This article was originally published in the September/October 2017 edition of "The Houston Lawyer" magazine [...]read more
On 4/1/2018, the new law will end the current practice where doctors can secretly enter a DNR order against patient and family wishes
This article was originally published in the September/October 2017 edition of "The Houston Lawyer" magazine
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