How doctors celebrate Labor Day—24-hour shifts,168-hour work weeks

Have you seen this bumper sticker?

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Today we celebrate hardworking Americans, the 40-hour work week, and safe working conditions with parades, picnics, and a day to rest.

Except doctors. They’re still at work.

At the height of the Industrial Revolution, Americans worked 12-hour days every day in unsafe factory-like settings with lack of breaks, water, food, and fresh air. Immigrants were treated even worse.

Industrialized assembly-line medicine now forces doctors to work up to 168-hour shifts with lack of access to food, sleep, fresh air, and breaks. Do the math: a 168-hour week means no sleep all week. 

America’s hospitals and clinics are filled with doctors who are not only subjected to poor physical conditions; they also suffer from mental health issues. Suicide is an occupational hazard in medicine where bullying, hazing, sleep deprivation is the norm.

LaborDay

Why should you care? Why not just enjoy your picnic with the family and sit back and watch the parade?

Because if you get in a car wreck on the way to the picnic you may be treated by a physician in the ICU who is constipated, hypoglycemic, and has not slept in 168 hours. Is this the person you want controlling your ventilator?

Is it legal to work 168 hours per week in America? Hospitals may impose 7-day shifts for doctors. Yes they can and do. This physician whistleblower tells all.

In 2011 doctors-in-training in America were supposed to be protected with 80-hour work week restrictions (maximum 24-hour shifts). However, these work-hour restrictions are unenforced. I hear from doctors in training all the time who are terrified to declare their actual number of work hours per week (120+) because of harassment and other repercussions that may end their careers. Oh and J-1 Visa (foreign doctors) can be fired and deported if they complain about unsafe working conditions.

The Accreditation Council for Graduate Medical Education (ACGME) imposed these more stringent resident work-hour restrictions in 2011,  prompted, in part, by a 2009 Institute of Medicine (IOM) report and based on substantial evidence that sleep deprivation in medical residents increases the risk of medical errors for patients and serious harms for residents (including motor vehicle accidents, needle stick injuries, and depression). Now there are proposals to roll back these resident work-hour restrictions. 

Are you a physician who has been injured by sleep deprivation and unsafe working conditions? Are you a patient who is outraged that your physician is working 24-hour shifts? Or 168-hour work weeks? The time to speak up is now. Sign this petition to demand safe working conditions for doctors then leave your comment on this blog.

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Pamela Wible, M.D., is an investigative reporter and whistleblower who advocates for physicians and patients injured by unsafe working condition in America’s hospitals and clinics. Have a story to share? Please contact Dr. Wible.

9 comments on “How doctors celebrate Labor Day—24-hour shifts,168-hour work weeks
  1. James says:

    Who is insisting on these long hours? The management, the insurance companies, the doctors themselves, or is it just a broken system? When I read your line “Because if you get in a car wreck on the way to the picnic..” I thought “it will probably be because a doctor coming off a 24hr shift hit you”. Of course you say that very thing later “2009 Institute of Medicine (IOM) report and based on substantial evidence that sleep deprivation in medical residents increases the risk of medical errors for patients and serious harms for residents (including motor vehicle accidents”. If you have not already seen it you might enjoy this commentary in the Washington Post which quotes research showing productivity plummets when weekly work hours exceed 55 hours per week.
    https://www.washingtonpost.com/news/on-leadership/wp/2016/09/01/stop-touting-the-crazy-hours-you-work-it-helps-no-one-2/

  2. John Bechtel says:

    I am a writer currently working out of a hostel in Buenos Aires, Argentina and last week I had the pleasure of a new roommate, a young doctor Felipe, in “residency” in his native country of Colombia. In a long interview he related to me some of the tough choices to be made in South America between money/prestige and humanity/caring. I told him about your ideal medical clinics and about the suicide rate among American doctors. He raised his eyebrows in surprise at that, but then informed me that doctors in his country are required to work in remote small towns and villages for one year before they can open their own practice. Unfortunately when a villager under a doctor’s care gets sicker or even dies, it sometimes costs the doctor his life as outraged relatives and friends of the deceased blame the doctor and seek revenge. Felipe says he has lost several of his medical peers from such vigilante “malpractice” retribution. Both the local police and the military look the other way. Felipe is going to be a very dedicated doctor and I hope he contacts you. He is in the profession for all the right reasons.

    • Pamela Wible MD says:

      OMG. That’s an occupational hazard I had not even thought about!! And to think we enter this field just wanting to “help other people heal.” What a toll this profession takes on us. Thanks for sharing John.

  3. Lori Smith says:

    7 days on, 7 days off is common for hospitalists. What is just as bizarre is that these job offers come into my inbox multiple times per day, titled, “EXCELLENT OPPORTUNITY!!!” “FANTASTIC CHANCE TO HAVE GREAT QUALITY OF LIFE!!!” I used to reply, “Fantastic for whom?” Ah yes, for the hospital administration and the recruiter. Everyone else loses. Maybe the sacred physician patient relationship should be renamed ‘scared’, depending on the health of your doctor.

  4. Asha Kamnani says:

    Yes, I know exactly how it feels. For 25 plus years I have worked every holiday because they told me I am a Hindu and I do not celebrate these holidays. I have been an American citizen for more than 25 years. I did these 24 hour shifts while everyone else celebrated. July 4th, 2016 , my first holiday watching fireworks since 1987.

  5. Well, Doc, I must say that we have all been set up to fail each other and the society. 33 years in medicine to discover that we have been treating pain incorrectly causing harm and more pain ultimately leading to dozens of Americans committing suicide per day. 22/day in Veterans.

    We were taught to order x-rays and MRIs so we can see the location of pain on the images.

    Do you know it is impossible to see pain with the human eye or any technology?
    Did you know it is impossible for the skeleton to be the primary location and source of pain that everyone feels and their bodies?

    Did you know the concept of arthritis is made up? Meaning the word arthritis is the distraction or deception.

    Is taken me 18 of my 33 years to discover that pain in the body’s natural, healthy and expected.

    I’ve also rediscovered some old-school original treatments for, and natural and healthy pain that we will all get every day which is in our muscular system.

    Also rediscovered that massage is the original treatment for muscle-derived pain.
    Chiropractic caregivers are original healers for muscle-derived pain.
    The use of knobs, probes, bars, rolls, and hot needles to affect a cure in the body is as old as humanity.

    I also discovered that in the 60s there were a group of doctors who put all this together in a beautiful dossier explaining to the world that pain in the body could readily be even eradicated with a spectrum of physical therapy options from hands on as and massage and intramuscular with thin needling.

    Read C Chan Gunn M.D.

    Did you know the idea of removing body parts to treat pain was made up for profits?
    Did you know that prescribing opiate derivatives for pain are the only other option our society has decided to use when removing a body part doesn’t work?

    I’m sure you’ve often wondered why patients continue to complain of pain after they had surgery this is because you can use surgery to remove pain from muscles. You can only use manual labor.

    When a physician cannot see to restore someone back to a well and ready state of comfort and joy, you lose your sense of worth.

  6. Suzan Donner says:

    Really, just doctors?
    Try going out into the field with a paramedic where are on the true front line of the car wreck, suicides and goriest sites that are cleaned up before the doctor sees what has happened.
    Now let’s talk about the pay. These paramedics are at about $15/hour. They have a degree that is equal to the nurses that are working in the hospital with these sleep deprived doctors and the nurses cannot give the drugs or act without a doctor’s orders, unlike a paramedic that must make a split decision that can save a patient’s life.
    Now let’s talk about sleep deprivation. Who really goes through that besides a doctor? Try a paramedic. Does the doctor have to repell down a steep cliff to get to a patient, treat the patient and then safety drive the patient to the hospital?
    At least the doctor has not had the physical challenges a paramedic has, a doctor has a cafeteria and a toilet close.
    You obviously have never walked in a paramedic’s shoes, especially one that lives in the country setting, so before you wine and cry about how hard a doctor has it, try the life of a paramedic.

    • Pamela Wible MD says:

      Not just doctors. EMTs and veterinarians, and many other professions. This is not about pitting one profession against another for who has it worse. I’m only writing about my personal experiences and those of my colleagues. Utmost respect for all healers.

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