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CNN Live Sunday
Exhausted Residents Can Take Toll On Patient Care
Aired June 17, 2001 - 16:11 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
DONNA KELLEY, CNN ANCHOR: The traditional practice of training new doctors, making them work for days on end with little rest, is an accepted practice in the medical profession. As CNN's medical correspondent Dr. Sanjay Gupta reports, it's also taking a toll though on doctors, and perhaps on patient care as well.
(BEGIN VIDEOTAPE)
SANJAY GUPTA, CNN CORRESPONDENT (voice-over): David Grande and his fiancee haven't taken their wedding vows yet, but they recently took another vow. The Hippocratic oath, when they finished medical school.
It begins first: Do no harm. Now, as medical students, they are finding hard to keep that vow.
DR. DAVID GRANDE, RESIDENT PHYSICIAN: It's really impossible to perform at your best after you have been away for such a long period of time.
GUPTA: Their job has many old traditions.
GRANDE: Based on a tradition in medicine, where long hours, equal better doctors.
GUPTA: And very little sleep.
GRANDE: I definitely feel overworked.
GUPTA: In many hospitals, the large part of the care is delivered by residents. Most residents work 80 to 100 hours a week with surgical residents often working more than 110 hours a week.
JAYA AGRAWAL: It's something everybody inside medical community knows about; it's something we talk about on a regular basis. It's just not something that people talk about publicly.
GUPTA: Could this be a problem? Jaya Agrawal, the president of American Medical Student Association thinks so.
AGRAWAL: When you have been away for more than 24 hours, your hand-eye coordination is equivalent to someone who has been intoxicated.
GUPTA: How bad is it? She quotes a study from the Journal of the American Medical Association.
AGRAWAL: Six out of seven residents had fallen asleep while driving home. You need to ask yourself, is this somebody you want to be on the road with? Or more importantly, is this somebody you want operating on you?
GUPTA: Patients may no longer be priority number one.
GRANDE: Patients sometimes become the enemy to the resident because it's really standing between you and getting one hour of sleep.
GUPTA: But patients aren't the enemy, says groups such as AMSA, it's the system.
AGRAWAL: Currently there are no laws on the books that limit resident-physician work hours.
GUPTA: That may change, as Congressman John Conyers of Michigan works on legislation to limit resident work hours, and soon the AMA will meet to vote on the stance.
DR. RICHARD CORLIN, PRESIDENT-ELECT, AMA: We need to take a look again at the issue of, why is the resident there? The resident is not there for the purpose of providing service to patients that they don't have attending physicians for. The resident is there to learn his or her specialty.
GUPTA: There are ways to lighten the load on the residents and still provide quality care.
DR. SINDHU SRINIVAS, RESIDENT-PHYSICIAN: A lot of work can be done by other support staff in the hospital.
GUPTA: But the hospitals would have to hire that staff. A reduction in doctors' hours could mean an increase in hospital expenses.
CORLIN: There's a tremendous burden placed on those institutions. They are doing the best they can to try to meet this burden by using everyone to provide the care to these people.
GUPTA: But this burden might prevent young doctors from keeping his vows.
(on camera): Doctors are required to be confident, competent, and compassionate -- this, while working two to three times a normal work week. And taking patients' lives into their hands. As national reform gains momentum, the challenge will be to make sure the changes are suitable for everyone. Most importantly, the patients.
Dr. Sanjay Gupta, CNN, reporting.
(END VIDEOTAPE)
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