Archives for July 14, 2003

Night Shift Study

Scary truths about the graveyard shift Circadian Technologies (a ‘consultancy’) has found some things about night shifts:

Graveyard-shift workers make five times as many serious mistakes and are 20 percent more likely to suffer severe accidents.

Those on the overnight shift also have a significantly higher incidence of costly diseases and disorders, costing employers billions.

…divorce rates are as high as 60 percent among all-night workers, and why they have 150 percent more stress-related gastrointestinal disorders.

The medically related:

On July 1, the Accreditation Council for Graduate Medical Education, the national body that oversees medical residents, mandated paring back residents? brutal 100-hour workweeks to 80 hours, and reducing their 30-plus hour patient-care shifts to a maximum of 24.

I’ve been told, and have no reason to doubt, that a disproportionate number of medical mistakes happen at about 0400.

I’ll keep all this in mind while I’m working the night shift this month.

Challenge to Residency Training Thrown Out – Judge Dismisses Daniel v. ABEM Lawsuit

A federal judge upheld an earlier recommendation that a 13-year-old antitrust lawsuit challenging the requirements for emergency physician certification be dismissed.

Gregory F. Daniel, MD, later joined by more than 100 other physicians who are not residency trained in emergency medicine, sued the American Board of Emergency Medicine (ABEM) in 1990, claiming that their practice experience should allow them to take the certification exam, and that ABEM is conspiring to restrain trade and exclude non-certified emergency physicians from practice.

On June 20, US District Judge Richard Arcara granted the defendants? motion to dismiss the case and entered a final judgment in favor of ABEM.

The plaintiffs can still appeal with the Second Circuit Court of Appeals, and must file a notice of intent to do so by the end of July. Representatives for the plaintiffs could not be reached for comment.

ABEM, which was formed in the 1970s, administers a certifying exam in emergency medicine where physicians, once deemed eligible, may become ABEM certified in emergency medicine as a specialist if they pass the written and oral examinations. Many physicians attained certification though the so-called ?practice track,? which required 7,000 hours and 60 months practice in emergency medicine, among other criteria. The practice track closed in 1988 when formal residency training in emergency medicine became a required prerequisite for eligibility to take the ABEM exam.

Residency training can by the only real path to certification. All specialties started with a ‘practice track’ because it was a brand new specialty, docs with vision tried it out, and it their specialty made sense and was accepted enough that then formal training was set up to produce more of the specialists.

This suit was a bad idea to start with, and hasn’t gotten any better with time.