List Archives

Thu May 7 18:52:21 BST 2009

been there, done that-- and still understand both sides.

still in Family Medicine, all the new physicians (and they are hungry for
new Primary Care folks!!) ALL WANT 9-5, no weekends, no holidays and a home
life.

Maybe it is us who were wrong?!

cmm

On Thu, May 7, 2009 at 1:46 PM, <nappio at aol.com> wrote:

> I think that is a short sighted statement and would argue you would want a
> battle seasoned soldier making tactical decisions in the heat of battle
> rather then a green recruit.  Remember, you ultimately got very good at
> working sleep deprived as did most of us. There is no other way to learn how
> to manage chaos.  Most hospitals don't have house staff so you better have
> learned how to operate alone, tired and well.dave nap md
> Sent from my Verizon Wireless BlackBerry
>
> -----Original Message-----
> From: Charlene M Morris <cvmmorris at gmail.com>
>
> Date: Thu, 7 May 2009 13:16:49
> To: Trauma and Critical Care mailing list<trauma-list at trauma.org>
>  Subject: Sleep deprived Critical Care?
>
>
> As a PA for almost 30 years, I have pulled my share of 24 hour shifts and
> really do appreciate the learning experience that cam with the brutal "stay
> awake" edict. Still, as our community hospital changed to 10 hour shifts
> (yay!) and residency requirements are down-sized, I too-- applaude.
>
> Some important life-saving decisions are made under those stressful
> conditions-- and you yourself: would you want someone rested and with full
> acuity-- or a bleary-eyed clinician "doing their best"
>
> Remember: sleep deprivation is one of the most effective torture
> techniques,
> because it works.
>
> cmm
>
> On Thu, May 7, 2009 at 10:30 AM, Teperman, Sheldon <
> Sheldon.Teperman at nbhn.net> wrote:
>
> >
> >
> >
> > "Fire makes steel strong in
> > > the
> > > same way challenges toughen a person"..
> >
> >         It is precisely comments like this that required the NYState
> > legislature to pass a law requiring stiff penalties for breaking ( the
> all
> > ready passed) law regarding resident hours.  Leaders in surgery in this
> > state were disingenuous with following the new rules.  They would have
> two
> > sets of "books" ( if you will) with the real and then the "doctored" call
> > schedule. Gentleman( ladies), get real.  Reflect for a moment how many of
> > your colleagues have become victims of Substance abuse, broken marriages
> and
> > even suicide or mental illness. I can think of many examples of each of
> > these in my fellow residents from the " good old days". Where is the
> virtue
> > and the "true calling" in that???
> >
> >        These were young, bright people whose lives were ruined by the
> > crushing and completely unnecessary work burden of Residency.  We shame
> > ourselves, for suggesting that only we have the commitment and that young
> > people lack the drive or will to be surgeons. Think of the patients never
> > served and the operations never performed by those of us unfortunate
> enough
> > not to have survived those grueling times. Rather than carrying forward
> with
> > the torch of bravado, we should move on. Programs, that address the
> changes
> > necessary to adapt to these different times should be where words on
> these
> > pages lye.  For example, Len Jacobs' ATOM course or the simulations labs
> > cropping up all over the country address the issue of decreased resident
> > exposure to clinical material.  These are constructive programs of real
> > value, rather than the "Brutane" of old.
> >
> >
> >          I suggest we look to ourselves, before criticizing  our younger
> > colleagues. We are to blame for those lost lives and lost careers. How
> many
> > of those broken homes and mental break downs are we responsible for with
> our
> > "Dinosaur" like attitudes?  In the words of Gomar Pile,  ...For Shame,
> For
> > Shame , For Shame.!   Sheldon
> >
> >
> > -----Original Message-----
> > From: trauma-list-bounces at trauma.org [mailto:
> > trauma-list-bounces at trauma.org] On Behalf Of
> > trauma-list-request at trauma.org
> > Sent: Thursday, May 07, 2009 7:00 AM
> > To: trauma-list at trauma.org
> > Subject: trauma-list Digest, Vol 71, Issue 10
> >
> > Send trauma-list mailing list submissions to
> >        trauma-list at trauma.org
> >
> > To subscribe or unsubscribe via the World Wide Web, visit
> >        http://list.mistral.net/mailman/listinfo/trauma-list
> > or, via email, send a message with subject or body 'help' to
> >        trauma-list-request at trauma.org
> >
> > You can reach the person managing the list at
> >        trauma-list-owner at trauma.org
> >
> > When replying, please edit your Subject line so it is more specific than
> > "Re: Contents of trauma-list digest..."
> >
> >
> > Today's Topics:
> >
> >   1. RE: to Doc Holiday-DELAYED response (Gross, Ronald)
> >   2. RE: Blunt CCA injury ina stable YOUNG pt (Gross, Ronald)
> >   3. Re: Blunt CCA injury ina stable YOUNG pt (Ante ?ori?)
> >   4. Re: to Doc Holiday-DELAYED response (Jose Luis Danguilan)
> >   5. Re: to Doc Holiday-DELAYED response (Andre Carneiro)
> >   6. Re: to Doc Holiday-DELAYED response (jduchesn at tulane.edu)
> >   7. Re: to Doc Holiday-DELAYED response (Tidewater001)
> >   8. RE: to Doc Holiday-DELAYED response (Gross, Ronald)
> >   9. RE: to Doc Holiday-DELAYED response (Gross, Ronald)
> >
> >
> > ----------------------------------------------------------------------
> >
> > Message: 1
> > Date: Wed, 6 May 2009 07:26:56 -0400
> > From: "Gross, Ronald" <Ronald.Gross at baystatehealth.org>
> > Subject: RE: to Doc Holiday-DELAYED response
> > To: "'Trauma and Critical Care mailing list'" <trauma-list at trauma.org>
> > Message-ID:
> >        <FD2BE6867A90F543AAD02E429F878633013B1FBC0BC6 at bhsexc11.bhs.org>
> > Content-Type: text/plain; charset="us-ascii"
> >
> > And when you finally finish your truncated 5 year surgical residency,
> with
> > protected educational time, sleep time and no more that 80 hours per
> week,
> > and you have to go out into the REAL world, will your patients understand
> > that you need to go home now 'cause you're sleepy, and someone they have
> > never seen will be caring for them?
> >
> > Athletes learn endurance by working harder and longer in their workouts
> > then they have to do in the "real deal".  Our stakes are FAR higher than
> any
> > athletes' stakes, and yet we are failing to teach our residents the
> expanse
> > of knowledge they will need, and we are failing to prepare them for the
> real
> > world, where there isn't protected education time, and guaranteed sleep
> > time.
> >
> > I know, my wife has told me on several occasions that I am a dinosaur.
>  She
> > is probably right.....but this dinosaur has been true to his calling, and
> > will never stop being fully responsible for the care of his patients -
> all
> > the time!
> >
> > (OOPS, need to take a nap now.  Worked too long.........)
> >
> > Best to you all,
> > Ron
> >
> >
> >
> > -----Original Message-----
> > From: trauma-list-bounces at trauma.org [mailto:
> > trauma-list-bounces at trauma.org] On Behalf Of khumar huseynova
> > Sent: Tuesday, May 05, 2009 4:50 PM
> > To: trauma-list at trauma.org
> > Subject: to Doc Holiday-DELAYED response
> >
> > Dr Holiday, sorry for retarded response-just read your note on resident
> > hours (March). Thanks and yes, you are right, there is evidence that long
> > hours result in reduced effciency and eventual harm to the patient. I
> dont
> > think I will ever agree witht eh 48hr/wk schedule for SURGERY
> residents-it
> > has to be MORE than that. Am not saying 120hrs, but should be reasonable
> > enough to get suffucuent experience and not to feel 'dead' at the end of
> the
> > day. Maybe someone needs to design a study to determine the cutoff...
> > And you are right, there are perhaps other ways of increasing the quality
> > of residency without making the hours too long as well. The problem is,
> > given how conservative the health care system is, it will take decades to
> > change it.
> > Cheers. KH
> >
> >
> >
> >      __________________________________________________________________
> > Get a sneak peak at messages with a handy reading pane with All new
> Yahoo!
> > Mail: http://ca.promos.yahoo.com/newmail/overview2/
> > --
> > trauma-list : TRAUMA.ORG <http://trauma.org/> <http://trauma.org/>
>  > To change your settings or unsubscribe visit:
> > http://www.trauma.org/index.php?/community/
> >
> > ----------------------------------------------------------------------
> > CONFIDENTIALITY NOTICE: This email communication and any attachments may
> > contain confidential and privileged information for the use of the
> > designated recipients named above. If you are not the intended recipient,
> > you are hereby notified that you have received this communication in
> error
> > and that any review, disclosure, dissemination, distribution or copying
> of
> > it or its contents is prohibited. If you have received this communication
> in
> > error, please reply to the sender immediately or by telephone at (413)
> > 794-0000 and destroy all copies of this communication and any
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> > For further information regarding Baystate Health's privacy policy,
> please
> > visit our Internet web site at http://www.baystatehealth.com.
> >
> >
> > ------------------------------
> >
> > Message: 2
> > Date: Wed, 6 May 2009 07:36:39 -0400
> > From: "Gross, Ronald" <Ronald.Gross at baystatehealth.org>
> > Subject: RE: Blunt CCA injury ina stable YOUNG pt
> > To: "'Trauma and Critical Care mailing list'" <trauma-list at trauma.org>
> > Message-ID:
> >        <FD2BE6867A90F543AAD02E429F878633013B1FBC0BC7 at bhsexc11.bhs.org>
> > Content-Type: text/plain; charset="us-ascii"
> >
> > How about an image or two?  Before I respond to this very complex issue
> > that has, to my knowledge, no real definitive answer in the surgical or
> > neurosurgical literature, why did you scan the patient in the first
> place?
> >  "Post-blunt trauma" is a pretty broad category....trauma where?  Was the
> > c-spine injured?  Was the blunt trauma directly to the neck?  Was this a
> > seatbelt across the neck?
> >
> > And lastly - is the really an injury, to refer to a phrase coined by Ken
> > Mattox, is this just VOMIT?
> >
> > Ron
> >
> > -----Original Message-----
> > From: trauma-list-bounces at trauma.org [mailto:
> > trauma-list-bounces at trauma.org] On Behalf Of khumar huseynova
> > Sent: Tuesday, May 05, 2009 4:53 PM
> > To: trauma-list at trauma.org
> > Subject: Blunt CCA injury ina stable YOUNG pt
> >
> > 24M w post-blunt trauma. Stable. Has intimal dissection of common carotid
> > art w 50% lumen obstruction. Asymptomatic from injury currently. No other
> > injuries. What would you do-anticoagulate w LOW-dose heparin; give ASA
> only;
> > stent; or operate?
> > KH
> >
> >
> >      __________________________________________________________________
> > Looking for the perfect gift? Give the gift of Flickr!
> >
> > http://www.flickr.com/gift/
> > --
> > trauma-list : TRAUMA.ORG <http://trauma.org/> <http://trauma.org/>
>  > To change your settings or unsubscribe visit:
> > http://www.trauma.org/index.php?/community/
> >
> > ----------------------------------------------------------------------
> > CONFIDENTIALITY NOTICE: This email communication and any attachments may
> > contain confidential and privileged information for the use of the
> > designated recipients named above. If you are not the intended recipient,
> > you are hereby notified that you have received this communication in
> error
> > and that any review, disclosure, dissemination, distribution or copying
> of
> > it or its contents is prohibited. If you have received this communication
> in
> > error, please reply to the sender immediately or by telephone at (413)
> > 794-0000 and destroy all copies of this communication and any
> attachments.
> > For further information regarding Baystate Health's privacy policy,
> please
> > visit our Internet web site at http://www.baystatehealth.com.
> >
> >
> > ------------------------------
> >
> > Message: 3
> > Date: Wed, 6 May 2009 15:00:57 +0200
> > From: Ante ?ori? <ante.coric85 at gmail.com>
> > Subject: Re: Blunt CCA injury ina stable YOUNG pt
> > To: Trauma and Critical Care mailing list <trauma-list at trauma.org>
> > Message-ID:
> >        <edddfb3e0905060600t5e9a462aid63e78b889df0f67 at mail.gmail.com>
> > Content-Type: text/plain; charset=ISO-8859-1
> >
> > if the lesion is withdrawing by time l see no need for anticoagulation,
> > instead l would repeat ultrasound and see the situation, but if in any
> > doubt, or unable to do any diagnostic test in short period of time, l
> would
> > anticoagulate him for a while, if otherwise healthy  young person... but
> l
> > don't think there is a great chance of him stroking because even in this
> > situation 50% lumen is more then sufficient to provide enough blood flow,
> > and if no major turbulence risk for endothelial injury thrombus genesis
> is
> > practically 100% not happening if lumen doesn't spread on its own, then
> > would consider intervening, surgically or radiology intervention Ante
> >
> > 2009/5/6 Gross, Ronald <Ronald.Gross at baystatehealth.org>
> >
> > > How about an image or two?  Before I respond to this very complex
> > > issue that has, to my knowledge, no real definitive answer in the
> > > surgical or neurosurgical literature, why did you scan the patient in
> the
> > first place?
> > >  "Post-blunt trauma" is a pretty broad category....trauma where?  Was
> > > the c-spine injured?  Was the blunt trauma directly to the neck?  Was
> > > this a seatbelt across the neck?
> > >
> > > And lastly - is the really an injury, to refer to a phrase coined by
> > > Ken Mattox, is this just VOMIT?
> > >
> > > Ron
> > >
> > > -----Original Message-----
> > > From: trauma-list-bounces at trauma.org [mailto:
> > > trauma-list-bounces at trauma.org] On Behalf Of khumar huseynova
> > > Sent: Tuesday, May 05, 2009 4:53 PM
> > > To: trauma-list at trauma.org
> > > Subject: Blunt CCA injury ina stable YOUNG pt
> > >
> > > 24M w post-blunt trauma. Stable. Has intimal dissection of common
> > > carotid art w 50% lumen obstruction. Asymptomatic from injury
> > > currently. No other injuries. What would you do-anticoagulate w
> > > LOW-dose heparin; give ASA only; stent; or operate?
> > > KH
> > >
> > >
> > >
> > > __________________________________________________________________
> > > Looking for the perfect gift? Give the gift of Flickr!
> > >
> > > http://www.flickr.com/gift/
> > > --
> > > trauma-list : TRAUMA.ORG <http://trauma.org/> <http://trauma.org/>
> > > To change your settings or unsubscribe visit:
> > > http://www.trauma.org/index.php?/community/
> > >
> > > ----------------------------------------------------------------------
> > > CONFIDENTIALITY NOTICE: This email communication and any attachments
> > > may contain confidential and privileged information for the use of the
> > > designated recipients named above. If you are not the intended
> > > recipient, you are hereby notified that you have received this
> > > communication in error and that any review, disclosure, dissemination,
> > > distribution or copying of it or its contents is prohibited. If you
> > > have received this communication in error, please reply to the sender
> > > immediately or by telephone at (413) 794-0000 and destroy all copies of
> > this communication and any attachments.
> > > For further information regarding Baystate Health's privacy policy,
> > > please visit our Internet web site at http://www.baystatehealth.com.
> > > --
> > > trauma-list : TRAUMA.ORG <http://trauma.org/> <http://trauma.org/>
>  > > To change your settings or unsubscribe visit:
> > > http://www.trauma.org/index.php?/community/
> > >
> >
> >
> > ------------------------------
> >
> > Message: 4
> > Date: Thu, 7 May 2009 04:23:31 +0800
> > From: Jose Luis Danguilan <jdanguilan at gmail.com>
> > Subject: Re: to Doc Holiday-DELAYED response
> > To: Trauma and Critical Care mailing list <trauma-list at trauma.org>
> > Message-ID:
> >        <17d66fd60905061323u38c6dacaqef3a8f7e97be68c2 at mail.gmail.com>
> > Content-Type: text/plain; charset=ISO-8859-1
> >
> > I fully agree with Dr. Gross. We seem to baby the new generation of
> > surgical residents. Hard work has never killed anyone. Fire makes steel
> > strong in the same way challenges toughen a person or did I get my
> metaphors
> > mixed up?
> >
> > A fellow triceratops,
> >
> > Jose Luis J. Danguilan, MD
> > Manila, Philippines
> >
> > On Wed, May 6, 2009 at 7:26 PM, Gross, Ronald <
> > Ronald.Gross at baystatehealth.org> wrote:
> >
> > > And when you finally finish your truncated 5 year surgical residency,
> > > with protected educational time, sleep time and no more that 80 hours
> > > per week, and you have to go out into the REAL world, will your
> > > patients understand that you need to go home now 'cause you're sleepy,
> > > and someone they have never seen will be caring for them?
> > >
> > > Athletes learn endurance by working harder and longer in their
> > > workouts then they have to do in the "real deal".  Our stakes are FAR
> > > higher than any athletes' stakes, and yet we are failing to teach our
> > > residents the expanse of knowledge they will need, and we are failing
> > > to prepare them for the real world, where there isn't protected
> > > education time, and guaranteed sleep time.
> > >
> > > I know, my wife has told me on several occasions that I am a dinosaur.
> > > She is probably right.....but this dinosaur has been true to his
> > > calling, and will never stop being fully responsible for the care of
> > > his patients - all the time!
> > >
> > > (OOPS, need to take a nap now.  Worked too long.........)
> > >
> > > Best to you all,
> > > Ron
> > >
> > >
> > >
> > > -----Original Message-----
> > > From: trauma-list-bounces at trauma.org [mailto:
> > > trauma-list-bounces at trauma.org] On Behalf Of khumar huseynova
> > > Sent: Tuesday, May 05, 2009 4:50 PM
> > > To: trauma-list at trauma.org
> > > Subject: to Doc Holiday-DELAYED response
> > >
> > > Dr Holiday, sorry for retarded response-just read your note on
> > > resident hours (March). Thanks and yes, you are right, there is
> > > evidence that long hours result in reduced effciency and eventual harm
> > > to the patient. I dont think I will ever agree witht eh 48hr/wk
> > > schedule for SURGERY residents-it has to be MORE than that. Am not
> > > saying 120hrs, but should be reasonable enough to get suffucuent
> > > experience and not to feel 'dead' at the end of the day. Maybe someone
> > needs to design a study to determine the cutoff...
> > > And you are right, there are perhaps other ways of increasing the
> > > quality of residency without making the hours too long as well. The
> > > problem is, given how conservative the health care system is, it will
> > > take decades to change it.
> > > Cheers. KH
> > >
> > >
> > >
> > >
> > > __________________________________________________________________
> > > Get a sneak peak at messages with a handy reading pane with All new
> > Yahoo!
> > > Mail: http://ca.promos.yahoo.com/newmail/overview2/
> > > --
> > > trauma-list : TRAUMA.ORG <http://trauma.org/> <http://trauma.org/>
> > > To change your settings or unsubscribe visit:
> > > http://www.trauma.org/index.php?/community/
> > >
> > > ----------------------------------------------------------------------
> > > CONFIDENTIALITY NOTICE: This email communication and any attachments
> > > may contain confidential and privileged information for the use of the
> > > designated recipients named above. If you are not the intended
> > > recipient, you are hereby notified that you have received this
> > > communication in error and that any review, disclosure, dissemination,
> > > distribution or copying of it or its contents is prohibited. If you
> > > have received this communication in error, please reply to the sender
> > > immediately or by telephone at (413) 794-0000 and destroy all copies of
> > this communication and any attachments.
> > > For further information regarding Baystate Health's privacy policy,
> > > please visit our Internet web site at http://www.baystatehealth.com.
> > > --
> > > trauma-list : TRAUMA.ORG <http://trauma.org/> <http://trauma.org/>
>  > > To change your settings or unsubscribe visit:
> > > http://www.trauma.org/index.php?/community/
> > >
> >
> >
> > ------------------------------
> >
> > Message: 5
> > Date: Wed, 6 May 2009 21:38:13 +0100
> > From: Andre Carneiro <a.carneiro at enflurane.com>
> > Subject: Re: to Doc Holiday-DELAYED response
> > To: Trauma and Critical Care mailing list <trauma-list at trauma.org>
> > Message-ID:
> >        <5e8268ac0905061338o731c8db2t77e625c354456e15 at mail.gmail.com>
> > Content-Type: text/plain; charset=ISO-8859-1
> >
> > Whilst I completely agree that we trainees are not being exposed to
> enough
> > workload (48 hours! Are they mad??), I would also like to remind you that
> no
> > athlete trains 80 hours a week (no matter how serious they are about
> their
> > performance) and high performing athletes are well aware of the risk of
> > overtraining.
> > Meaning that surely there must be a happy medium that doesn't mean we
> live
> > in a complete state of tiredness which, I believe, has been proven time
> and
> > again to lead to incidents of varying degrees of severity.
> >
> >
> > Best wishes from across the pond
> >
> >
> >
> > Andre de Castro Carneiro
> > Specialist Registrar
> > Anaesthetics and Critical Care
> > The Leeds Teaching Hospitals NHS Trust
> >
> > 2009/5/6 Jose Luis Danguilan <jdanguilan at gmail.com>
> >
> > > I fully agree with Dr. Gross. We seem to baby the new generation of
> > > surgical residents. Hard work has never killed anyone. Fire makes
> > > steel strong in the same way challenges toughen a person or did I get
> > > my metaphors mixed up?
> > >
> > > A fellow triceratops,
> > >
> > > Jose Luis J. Danguilan, MD
> > > Manila, Philippines
> > >
> > > On Wed, May 6, 2009 at 7:26 PM, Gross, Ronald <
> > > Ronald.Gross at baystatehealth.org> wrote:
> > >
> > > > And when you finally finish your truncated 5 year surgical
> > > > residency,
> > > with
> > > > protected educational time, sleep time and no more that 80 hours per
> > > week,
> > > > and you have to go out into the REAL world, will your patients
> > > > understand that you need to go home now 'cause you're sleepy, and
> > > > someone they have never seen will be caring for them?
> > > >
> > > > Athletes learn endurance by working harder and longer in their
> > > > workouts then they have to do in the "real deal".  Our stakes are
> > > > FAR higher than
> > > any
> > > > athletes' stakes, and yet we are failing to teach our residents the
> > > expanse
> > > > of knowledge they will need, and we are failing to prepare them for
> > > > the
> > > real
> > > > world, where there isn't protected education time, and guaranteed
> > > > sleep time.
> > > >
> > > > I know, my wife has told me on several occasions that I am a
> dinosaur.
> > >  She
> > > > is probably right.....but this dinosaur has been true to his
> > > > calling, and will never stop being fully responsible for the care of
> > > > his patients -
> > > all
> > > > the time!
> > > >
> > > > (OOPS, need to take a nap now.  Worked too long.........)
> > > >
> > > > Best to you all,
> > > > Ron
> > > >
> > > >
> > > >
> > > > -----Original Message-----
> > > > From: trauma-list-bounces at trauma.org [mailto:
> > > > trauma-list-bounces at trauma.org] On Behalf Of khumar huseynova
> > > > Sent: Tuesday, May 05, 2009 4:50 PM
> > > > To: trauma-list at trauma.org
> > > > Subject: to Doc Holiday-DELAYED response
> > > >
> > > > Dr Holiday, sorry for retarded response-just read your note on
> > > > resident hours (March). Thanks and yes, you are right, there is
> > > > evidence that long hours result in reduced effciency and eventual
> > > > harm to the patient. I
> > > dont
> > > > think I will ever agree witht eh 48hr/wk schedule for SURGERY
> > > residents-it
> > > > has to be MORE than that. Am not saying 120hrs, but should be
> > > > reasonable enough to get suffucuent experience and not to feel
> > > > 'dead' at the end of
> > > the
> > > > day. Maybe someone needs to design a study to determine the cutoff...
> > > > And you are right, there are perhaps other ways of increasing the
> > > > quality of residency without making the hours too long as well. The
> > > > problem is, given how conservative the health care system is, it
> > > > will take decades to change it.
> > > > Cheers. KH
> > > >
> > > >
> > > >
> > > >
> > > > __________________________________________________________________
> > > > Get a sneak peak at messages with a handy reading pane with All new
> > > Yahoo!
> > > > Mail: http://ca.promos.yahoo.com/newmail/overview2/
> > > > --
> > > > trauma-list : TRAUMA.ORG <http://trauma.org/> <http://trauma.org/>
> > > > To change your settings or unsubscribe visit:
> > > > http://www.trauma.org/index.php?/community/
> > > >
> > > > --------------------------------------------------------------------
> > > > -- CONFIDENTIALITY NOTICE: This email communication and any
> > > > attachments may contain confidential and privileged information for
> > > > the use of the designated recipients named above. If you are not the
> > > > intended recipient, you are hereby notified that you have received
> > > > this communication in
> > > error
> > > > and that any review, disclosure, dissemination, distribution or
> > > > copying
> > > of
> > > > it or its contents is prohibited. If you have received this
> > > > communication
> > > in
> > > > error, please reply to the sender immediately or by telephone at
> > > > (413) 794-0000 and destroy all copies of this communication and any
> > > attachments.
> > > > For further information regarding Baystate Health's privacy policy,
> > > please
> > > > visit our Internet web site at http://www.baystatehealth.com.
> > > > --
> > > > trauma-list : TRAUMA.ORG <http://trauma.org/> <http://trauma.org/>
> > > > To change your settings or unsubscribe visit:
> > > > http://www.trauma.org/index.php?/community/
> > > >
> > > --
> > > trauma-list : TRAUMA.ORG <http://trauma.org/> <http://trauma.org/>
>  > > To change your settings or unsubscribe visit:
> > > http://www.trauma.org/index.php?/community/
> > >
> > >
> >
> >
> > ------------------------------
> >
> > Message: 6
> > Date: Wed, 6 May 2009 20:53:41 +0000
> > From: jduchesn at tulane.edu
> > Subject: Re: to Doc Holiday-DELAYED response
> > To: "Trauma and Critical Care mailing list" <trauma-list at trauma.org>
> > Message-ID:
> >
> >
>  <379830282-1241643222-cardhu_decombobulator_blackberry.rim.net-395344921- at bxe1135.bisx.prod.on.blackberry
> > >
> >
> > Content-Type: text/plain
> >
> > How can we set a time schedule for the PRIVILEDGE of being trained as a
> > SURGEON?
> > The field of Surgery needs full time commitment not part time effort.
> > Duchesne
> > CharityOne- New Orleans
> > Sent via BlackBerry by AT&T
> >
> > -----Original Message-----
> > From: Andre Carneiro <a.carneiro at enflurane.com>
> >
> > Date: Wed, 6 May 2009 21:38:13
> > To: Trauma and Critical Care mailing list<trauma-list at trauma.org>
> > Subject: Re: to Doc Holiday-DELAYED response
> >
> >
> > Whilst I completely agree that we trainees are not being exposed to
> enough
> > workload (48 hours! Are they mad??), I would also like to remind you that
> > no
> > athlete trains 80 hours a week (no matter how serious they are about
> their
> > performance) and high performing athletes are well aware of the risk of
> > overtraining.
> > Meaning that surely there must be a happy medium that doesn't mean we
> live
> > in a complete state of tiredness which, I believe, has been proven time
> and
> > again to lead to incidents of varying degrees of severity.
> >
> >
> > Best wishes from across the pond
> >
> >
> >
> > Andre de Castro Carneiro
> > Specialist Registrar
> > Anaesthetics and Critical Care
> > The Leeds Teaching Hospitals NHS Trust
> >
> > 2009/5/6 Jose Luis Danguilan <jdanguilan at gmail.com>
> >
> > > I fully agree with Dr. Gross. We seem to baby the new generation of
> > > surgical
> > > residents. Hard work has never killed anyone. Fire makes steel strong
> in
> > > the
> > > same way challenges toughen a person or did I get my metaphors mixed
> up?
> > >
> > > A fellow triceratops,
> > >
> > > Jose Luis J. Danguilan, MD
> > > Manila, Philippines
> > >
> > > On Wed, May 6, 2009 at 7:26 PM, Gross, Ronald <
> > > Ronald.Gross at baystatehealth.org> wrote:
> > >
> > > > And when you finally finish your truncated 5 year surgical residency,
> > > with
> > > > protected educational time, sleep time and no more that 80 hours per
> > > week,
> > > > and you have to go out into the REAL world, will your patients
> > understand
> > > > that you need to go home now 'cause you're sleepy, and someone they
> > have
> > > > never seen will be caring for them?
> > > >
> > > > Athletes learn endurance by working harder and longer in their
> workouts
> > > > then they have to do in the "real deal".  Our stakes are FAR higher
> > than
> > > any
> > > > athletes' stakes, and yet we are failing to teach our residents the
> > > expanse
> > > > of knowledge they will need, and we are failing to prepare them for
> the
> > > real
> > > > world, where there isn't protected education time, and guaranteed
> sleep
> > > > time.
> > > >
> > > > I know, my wife has told me on several occasions that I am a
> dinosaur.
> > >  She
> > > > is probably right.....but this dinosaur has been true to his calling,
> > and
> > > > will never stop being fully responsible for the care of his patients
> -
> > > all
> > > > the time!
> > > >
> > > > (OOPS, need to take a nap now.  Worked too long.........)
> > > >
> > > > Best to you all,
> > > > Ron
> > > >
> > > >
> > > >
> > > > -----Original Message-----
> > > > From: trauma-list-bounces at trauma.org [mailto:
> > > > trauma-list-bounces at trauma.org] On Behalf Of khumar huseynova
> > > > Sent: Tuesday, May 05, 2009 4:50 PM
> > > > To: trauma-list at trauma.org
> > > > Subject: to Doc Holiday-DELAYED response
> > > >
> > > > Dr Holiday, sorry for retarded response-just read your note on
> resident
> > > > hours (March). Thanks and yes, you are right, there is evidence that
> > long
> > > > hours result in reduced effciency and eventual harm to the patient. I
> > > dont
> > > > think I will ever agree witht eh 48hr/wk schedule for SURGERY
> > > residents-it
> > > > has to be MORE than that. Am not saying 120hrs, but should be
> > reasonable
> > > > enough to get suffucuent experience and not to feel 'dead' at the end
> > of
> > > the
> > > > day. Maybe someone needs to design a study to determine the cutoff...
> > > > And you are right, there are perhaps other ways of increasing the
> > quality
> > > > of residency without making the hours too long as well. The problem
> is,
> > > > given how conservative the health care system is, it will take
> decades
> > to
> > > > change it.
> > > > Cheers. KH
> > > >
> > > >
> > > >
> > > >
>  __________________________________________________________________
> > > > Get a sneak peak at messages with a handy reading pane with All new
> > > Yahoo!
> > > > Mail: http://ca.promos.yahoo.com/newmail/overview2/
> > > > --
> > > > trauma-list : TRAUMA.ORG <http://trauma.org/> <http://trauma.org/>
> > > > To change your settings or unsubscribe visit:
> > > > http://www.trauma.org/index.php?/community/
> > > >
> > > >
> ----------------------------------------------------------------------
> > > > CONFIDENTIALITY NOTICE: This email communication and any attachments
> > may
> > > > contain confidential and privileged information for the use of the
> > > > designated recipients named above. If you are not the intended
> > recipient,
> > > > you are hereby notified that you have received this communication in
> > > error
> > > > and that any review, disclosure, dissemination, distribution or
> copying
> > > of
> > > > it or its contents is prohibited. If you have received this
> > communication
> > > in
> > > > error, please reply to the sender immediately or by telephone at
> (413)
> > > > 794-0000 and destroy all copies of this communication and any
> > > attachments.
> > > > For further information regarding Baystate Health's privacy policy,
> > > please
> > > > visit our Internet web site at http://www.baystatehealth.com.
> > > > --
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> > > > To change your settings or unsubscribe visit:
> > > > http://www.trauma.org/index.php?/community/
> > > >
> > > --
> > > trauma-list : TRAUMA.ORG <http://trauma.org/> <http://trauma.org/>
> > > To change your settings or unsubscribe visit:
> > > http://www.trauma.org/index.php?/community/
> > >
> > >
> > --
> > trauma-list : TRAUMA.ORG <http://trauma.org/> <http://trauma.org/>
>  > To change your settings or unsubscribe visit:
> > http://www.trauma.org/index.php?/community/
> >
> > ------------------------------
> >
> > Message: 7
> > Date: Wed,  6 May 2009 22:07:26 -0400
> > From: Tidewater001 <tidewater001 at aol.com>
> > Subject: Re: to Doc Holiday-DELAYED response
> > To: "Trauma and Critical Care mailing list" <trauma-list at trauma.org>
> > Message-ID: <54261d19.b463.4432.b629.8f13e4b82c2e at aol.com>
> > Content-Type: TEXT/plain; charset=us-ascii
> >
> > I just got home from my TYPICAL day of seeing patients in the office,
> > operating, rounding, teaching, administrative responsibilities, seeing
> > consults, teaching, responding to the emergent needs of my colleagues
> caring
> > for their patients, rounding, operating and finally...more paperwork. I
> just
> > sat down to open my e-mails at 2145...my day started at 0600. Typical day
> > for me and I enjoyed most all of it. Do the residents training today
> (most
> > of whom will be joining the ranks of private practice like myself)
> honestly
> > think their work week will only be 80 hours!!!?? In these days of ever
> > worsening reimbursement and ever increasing business costs...you have to
> > work LONG and HARD to make a living and to be available to your patients
> and
> > the physicians who need your help and expertise as a WELL TRAINED
> SURGEON.
> > My program director beat that into us and I am a FIRM believer that the
> > patient comes first and last and really does not care if you are tired
> when
> > they are the ones in need
> >
> >  of your help!!
> >
> > Gregory T. Squires, MD FACS
> > Clinical Assistant Professor of Surgery
> > Medical University of South Carolina
> > Director of Trauma
> > Trident Regional Medical Center
> > Charleston, SC
> >
> >
> > In a message dated 05/06/09 16:56:04 Eastern Daylight Time,
> > jduchesn at tulane.edu writes:
> > How can we set a time schedule for the PRIVILEDGE of being trained as a
> > SURGEON?
> > The field of Surgery needs full time commitment not part time effort.
> > Duchesne
> > CharityOne- New Orleans
> > Sent via BlackBerry by AT&T
> >
> > -----Original Message-----
> > From: Andre Carneiro <a.carneiro at enflurane.com>
> >
> > Date: Wed, 6 May 2009 21:38:13
> > To: Trauma and Critical Care mailing list<trauma-list at trauma.org>
> > Subject: Re: to Doc Holiday-DELAYED response
> >
> >
> > Whilst I completely agree that we trainees are not being exposed to
> enough
> > workload (48 hours! Are they mad??), I would also like to remind you that
> > no
> > athlete trains 80 hours a week (no matter how serious they are about
> their
> > performance) and high performing athletes are well aware of the risk of
> > overtraining.
> > Meaning that surely there must be a happy medium that doesn't mean we
> live
> > in a complete state of tiredness which, I believe, has been proven time
> and
> > again to lead to incidents of varying degrees of severity.
> >
> >
> > Best wishes from across the pond
> >
> >
> >
> > Andre de Castro Carneiro
> > Specialist Registrar
> > Anaesthetics and Critical Care
> > The Leeds Teaching Hospitals NHS Trust
> >
> > 2009/5/6 Jose Luis Danguilan <jdanguilan at gmail.com>
> >
> > > I fully agree with Dr. Gross. We seem to baby the new generation of
> > > surgical
> > > residents. Hard work has never killed anyone. Fire makes steel strong
> in
> > > the
> > > same way challenges toughen a person or did I get my metaphors mixed
> up?
> > >
> > > A fellow triceratops,
> > >
> > > Jose Luis J. Danguilan, MD
> > > Manila, Philippines
> > >
> > > On Wed, May 6, 2009 at 7:26 PM, Gross, Ronald <
> > > Ronald.Gross at baystatehealth.org> wrote:
> > >
> > > > And when you finally finish your truncated 5 year surgical residency,
> > > with
> > > > protected educational time, sleep time and no more that 80 hours per
> > > week,
> > > > and you have to go out into the REAL world, will your patients
> > understand
> > > > that you need to go home now 'cause you're sleepy, and someone they
> > have
> > > > never seen will be caring for them?
> > > >
> > > > Athletes learn endurance by working harder and longer in their
> workouts
> > > > then they have to do in the "real deal".  Our stakes are FAR higher
> > than
> > > any
> > > > athletes' stakes, and yet we are failing to teach our residents the
> > > expanse
> > > > of knowledge they will need, and we are failing to prepare them for
> the
> > > real
> > > > world, where there isn't protected education time, and guaranteed
> sleep
> > > > time.
> > > >
> > > > I know, my wife has told me on several occasions that I am a
> dinosaur.
> > >  She
> > > > is probably right.....but this dinosaur has been true to his calling,
> > and
> > > > will never stop being fully responsible for the care of his patients
> -
> > > all
> > > > the time!
> > > >
> > > > (OOPS, need to take a nap now.  Worked too long.........)
> > > >
> > > > Best to you all,
> > > > Ron
> > > >
> > > >
> > > >
> > > > -----Original Message-----
> > > > From: trauma-list-bounces at trauma.org [mailto:
> > > > trauma-list-bounces at trauma.org] On Behalf Of khumar huseynova
> > > > Sent: Tuesday, May 05, 2009 4:50 PM
> > > > To: trauma-list at trauma.org
> > > > Subject: to Doc Holiday-DELAYED response
> > > >
> > > > Dr Holiday, sorry for retarded response-just read your note on
> resident
> > > > hours (March). Thanks and yes, you are right, there is evidence that
> > long
> > > > hours result in reduced effciency and eventual harm to the patient. I
> > > dont
> > > > think I will ever agree witht eh 48hr/wk schedule for SURGERY
> > > residents-it
> > > > has to be MORE than that. Am not saying 120hrs, but should be
> > reasonable
> > > > enough to get suffucuent experience and not to feel 'dead' at the end
> > of
> > > the
> > > > day. Maybe someone needs to design a study to determine the cutoff...
> > > > And you are right, there are perhaps other ways of increasing the
> > quality
> > > > of residency without making the hours too long as well. The problem
> is,
> > > > given how conservative the health care system is, it will take
> decades
> > to
> > > > change it.
> > > > Cheers. KH
> > > >
> > > >
> > > >
> > > >
>  __________________________________________________________________
> > > > Get a sneak peak at messages with a handy reading pane with All new
> > > Yahoo!
> > > > Mail: http://ca.promos.yahoo.com/newmail/overview2/
> > > > --
> > > > trauma-list : TRAUMA.ORG <http://trauma.org/> <http://trauma.org/>
> > > > To change your settings or unsubscribe visit:
> > > > http://www.trauma.org/index.php?/community/
> > > >
> > > >
> ----------------------------------------------------------------------
> > > > CONFIDENTIALITY NOTICE: This email communication and any attachments
> > may
> > > > contain confidential and privileged information for the use of the
> > > > designated recipients named above. If you are not the intended
> > recipient,
> > > > you are hereby notified that you have received this communication in
> > > error
> > > > and that any review, disclosure, dissemination, distribution or
> copying
> > > of
> > > > it or its contents is prohibited. If you have received this
> > communication
> > > in
> > > > error, please reply to the sender immediately or by telephone at
> (413)
> > > > 794-0000 and destroy all copies of this communication and any
> > > attachments.
> > > > For further information regarding Baystate Health's privacy policy,
> > > please
> > > > visit our Internet web site at http://www.baystatehealth.com.
> > > > --
> > > > trauma-list : TRAUMA.ORG <http://trauma.org/> <http://trauma.org/>
> > > > To change your settings or unsubscribe visit:
> > > > http://www.trauma.org/index.php?/community/
> > > >
> > > --
> > > trauma-list : TRAUMA.ORG <http://trauma.org/> <http://trauma.org/>
> > > To change your settings or unsubscribe visit:
> > > http://www.trauma.org/index.php?/community/
> > >
> > >
> > --
> > trauma-list : TRAUMA.ORG <http://trauma.org/> <http://trauma.org/>
> > To change your settings or unsubscribe visit:
> > http://www.trauma.org/index.php?/community/
> > --
> > trauma-list : TRAUMA.ORG <http://trauma.org/> <http://trauma.org/>
>  > To change your settings or unsubscribe visit:
> > http://www.trauma.org/index.php?/community/
> >
> >
> > ------------------------------
> >
> > Message: 8
> > Date: Thu, 7 May 2009 06:49:20 -0400
> > From: "Gross, Ronald" <Ronald.Gross at baystatehealth.org>
> > Subject: RE: to Doc Holiday-DELAYED response
> > To: "'Trauma and Critical Care mailing list'" <trauma-list at trauma.org>
> > Message-ID:
> >        <FD2BE6867A90F543AAD02E429F878633013B1FBC0BCB at bhsexc11.bhs.org>
> > Content-Type: text/plain; charset="us-ascii"
> >
> > You got 'em spot on!
> >
> > Ron
> > -----Original Message-----
> > From: trauma-list-bounces at trauma.org [mailto:
> > trauma-list-bounces at trauma.org] On Behalf Of Jose Luis Danguilan
> > Sent: Wednesday, May 06, 2009 4:24 PM
> > To: Trauma and Critical Care mailing list
> > Subject: Re: to Doc Holiday-DELAYED response
> >
> > I fully agree with Dr. Gross. We seem to baby the new generation of
> > surgical
> > residents. Hard work has never killed anyone. Fire makes steel strong in
> > the
> > same way challenges toughen a person or did I get my metaphors mixed up?
> >
> > A fellow triceratops,
> >
> > Jose Luis J. Danguilan, MD
> > Manila, Philippines
> >
> > On Wed, May 6, 2009 at 7:26 PM, Gross, Ronald <
> > Ronald.Gross at baystatehealth.org> wrote:
> >
> > > And when you finally finish your truncated 5 year surgical residency,
> > with
> > > protected educational time, sleep time and no more that 80 hours per
> > week,
> > > and you have to go out into the REAL world, will your patients
> understand
> > > that you need to go home now 'cause you're sleepy, and someone they
> have
> > > never seen will be caring for them?
> > >
> > > Athletes learn endurance by working harder and longer in their workouts
> > > then they have to do in the "real deal".  Our stakes are FAR higher
> than
> > any
> > > athletes' stakes, and yet we are failing to teach our residents the
> > expanse
> > > of knowledge they will need, and we are failing to prepare them for the
> > real
> > > world, where there isn't protected education time, and guaranteed sleep
> > > time.
> > >
> > > I know, my wife has told me on several occasions that I am a dinosaur.
> >  She
> > > is probably right.....but this dinosaur has been true to his calling,
> and
> > > will never stop being fully responsible for the care of his patients -
> > all
> > > the time!
> > >
> > > (OOPS, need to take a nap now.  Worked too long.........)
> > >
> > > Best to you all,
> > > Ron
> > >
> > >
> > >
> > > -----Original Message-----
> > > From: trauma-list-bounces at trauma.org [mailto:
> > > trauma-list-bounces at trauma.org] On Behalf Of khumar huseynova
> > > Sent: Tuesday, May 05, 2009 4:50 PM
> > > To: trauma-list at trauma.org
> > > Subject: to Doc Holiday-DELAYED response
> > >
> > > Dr Holiday, sorry for retarded response-just read your note on resident
> > > hours (March). Thanks and yes, you are right, there is evidence that
> long
> > > hours result in reduced effciency and eventual harm to the patient. I
> > dont
> > > think I will ever agree witht eh 48hr/wk schedule for SURGERY
> > residents-it
> > > has to be MORE than that. Am not saying 120hrs, but should be
> reasonable
> > > enough to get suffucuent experience and not to feel 'dead' at the end
> of
> > the
> > > day. Maybe someone needs to design a study to determine the cutoff...
> > > And you are right, there are perhaps other ways of increasing the
> quality
> > > of residency without making the hours too long as well. The problem is,
> > > given how conservative the health care system is, it will take decades
> to
> > > change it.
> > > Cheers. KH
> > >
> > >
> > >
> > >      __________________________________________________________________
> > > Get a sneak peak at messages with a handy reading pane with All new
> > Yahoo!
> > > Mail: http://ca.promos.yahoo.com/newmail/overview2/
> > > --
> > > trauma-list : TRAUMA.ORG <http://trauma.org/> <http://trauma.org/>
> > > To change your settings or unsubscribe visit:
> > > http://www.trauma.org/index.php?/community/
> > >
> > > ----------------------------------------------------------------------
> > > CONFIDENTIALITY NOTICE: This email communication and any attachments
> may
> > > contain confidential and privileged information for the use of the
> > > designated recipients named above. If you are not the intended
> recipient,
> > > you are hereby notified that you have received this communication in
> > error
> > > and that any review, disclosure, dissemination, distribution or copying
> > of
> > > it or its contents is prohibited. If you have received this
> communication
> > in
> > > error, please reply to the sender immediately or by telephone at (413)
> > > 794-0000 and destroy all copies of this communication and any
> > attachments.
> > > For further information regarding Baystate Health's privacy policy,
> > please
> > > visit our Internet web site at http://www.baystatehealth.com.
> > > --
> > > trauma-list : TRAUMA.ORG <http://trauma.org/> <http://trauma.org/>
> > > To change your settings or unsubscribe visit:
> > > http://www.trauma.org/index.php?/community/
> > >
> > --
> > trauma-list : TRAUMA.ORG <http://trauma.org/> <http://trauma.org/>
>  > To change your settings or unsubscribe visit:
> > http://www.trauma.org/index.php?/community/
> >
> >
> > ------------------------------
> >
> > Message: 9
> > Date: Thu, 7 May 2009 06:55:25 -0400
> > From: "Gross, Ronald" <Ronald.Gross at baystatehealth.org>
> > Subject: RE: to Doc Holiday-DELAYED response
> > To: "'Trauma and Critical Care mailing list'" <trauma-list at trauma.org>
> > Message-ID:
> >        <FD2BE6867A90F543AAD02E429F878633013B1FBC0BCD at bhsexc11.bhs.org>
> > Content-Type: text/plain; charset="us-ascii"
> >
> > >no athlete trains 80 hours a week<
> >
> > Correct....and no athlete is responsible for anyones' lives but their
> own.
> >
> > We are growing a new breed of physician - and they are apparently happy
> to
> > accept the shift work mentality.  Along with that goes the concept that
> once
> > they leave the hospital they have given up all of their responsibilities
> > until they return.
> >
> > Sad.  Very sad.  And scary, 'cause that same person is going to be caring
> > for YOU and ME one day, but only 8 hours at a time..........IF we are
> lucky
> > enough!
> >
> > Signed,
> > The Dinosaur
> >
> > -----Original Message-----
> > From: trauma-list-bounces at trauma.org [mailto:
> > trauma-list-bounces at trauma.org] On Behalf Of Andre Carneiro
> > Sent: Wednesday, May 06, 2009 4:38 PM
> > To: Trauma and Critical Care mailing list
> > Subject: Re: to Doc Holiday-DELAYED response
> >
> > Whilst I completely agree that we trainees are not being exposed to
> enough
> > workload (48 hours! Are they mad??), I would also like to remind you that
> > no
> > athlete trains 80 hours a week (no matter how serious they are about
> their
> > performance) and high performing athletes are well aware of the risk of
> > overtraining.
> > Meaning that surely there must be a happy medium that doesn't mean we
> live
> > in a complete state of tiredness which, I believe, has been proven time
> and
> > again to lead to incidents of varying degrees of severity.
> >
> >
> > Best wishes from across the pond
> >
> >
> >
> > Andre de Castro Carneiro
> > Specialist Registrar
> > Anaesthetics and Critical Care
> > The Leeds Teaching Hospitals NHS Trust
> >
> > 2009/5/6 Jose Luis Danguilan <jdanguilan at gmail.com>
> >
> > > I fully agree with Dr. Gross. We seem to baby the new generation of
> > > surgical
> > > residents. Hard work has never killed anyone. Fire makes steel strong
> in
> > > the
> > > same way challenges toughen a person or did I get my metaphors mixed
> up?
> > >
> > > A fellow triceratops,
> > >
> > > Jose Luis J. Danguilan, MD
> > > Manila, Philippines
> > >
> > > On Wed, May 6, 2009 at 7:26 PM, Gross, Ronald <
> > > Ronald.Gross at baystatehealth.org> wrote:
> > >
> > > > And when you finally finish your truncated 5 year surgical residency,
> > > with
> > > > protected educational time, sleep time and no more that 80 hours per
> > > week,
> > > > and you have to go out into the REAL world, will your patients
> > understand
> > > > that you need to go home now 'cause you're sleepy, and someone they
> > have
> > > > never seen will be caring for them?
> > > >
> > > > Athletes learn endurance by working harder and longer in their
> workouts
> > > > then they have to do in the "real deal".  Our stakes are FAR higher
> > than
> > > any
> > > > athletes' stakes, and yet we are failing to teach our residents the
> > > expanse
> > > > of knowledge they will need, and we are failing to prepare them for
> the
> > > real
> > > > world, where there isn't protected education time, and guaranteed
> sleep
> > > > time.
> > > >
> > > > I know, my wife has told me on several occasions that I am a
> dinosaur.
> > >  She
> > > > is probably right.....but this dinosaur has been true to his calling,
> > and
> > > > will never stop being fully responsible for the care of his patients
> -
> > > all
> > > > the time!
> > > >
> > > > (OOPS, need to take a nap now.  Worked too long.........)
> > > >
> > > > Best to you all,
> > > > Ron
> > > >
> > > >
> > > >
> > > > -----Original Message-----
> > > > From: trauma-list-bounces at trauma.org [mailto:
> > > > trauma-list-bounces at trauma.org] On Behalf Of khumar huseynova
> > > > Sent: Tuesday, May 05, 2009 4:50 PM
> > > > To: trauma-list at trauma.org
> > > > Subject: to Doc Holiday-DELAYED response
> > > >
> > > > Dr Holiday, sorry for retarded response-just read your note on
> resident
> > > > hours (March). Thanks and yes, you are right, there is evidence that
> > long
> > > > hours result in reduced effciency and eventual harm to the patient. I
> > > dont
> > > > think I will ever agree witht eh 48hr/wk schedule for SURGERY
> > > residents-it
> > > > has to be MORE than that. Am not saying 120hrs, but should be
> > reasonable
> > > > enough to get suffucuent experience and not to feel 'dead' at the end
> > of
> > > the
> > > > day. Maybe someone needs to design a study to determine the cutoff...
> > > > And you are right, there are perhaps other ways of increasing the
> > quality
> > > > of residency without making the hours too long as well. The problem
> is,
> > > > given how conservative the health care system is, it will take
> decades
> > to
> > > > change it.
> > > > Cheers. KH
> > > >
> > > >
> > > >
> > > >
>  __________________________________________________________________
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> --
> The one important thing I have learned over the years is the difference
> between taking one's work seriously and taking one's self seriously. The
> first is imperative and the second is disastrous.
> Margot Fonteyn
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-- 
The one important thing I have learned over the years is the difference
between taking one's work seriously and taking one's self seriously. The
first is imperative and the second is disastrous.
Margot Fonteyn

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