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by uxp100 2758 days ago
I was being tricky here but I mean the AMA.

It controls a great deal about doctor's education and working conditions. It does not collectively bargain, so it's not strictly a union. But it's more powerful than most unions at this point. So a glib, "maybe doctors should get a union to represent them" answer to poor working conditions for residents doesn't really make sense. They already have a powerful organization that should represent them.

I think that there is at least some group of physicians who really think that poor working conditions for residents improves patient outcomes and doctor training.
1 comments
ineedasername 2757 days ago
That is very true, the AMA is not formally a union, but it does exert a significant level of control and influence in standardizing the practices of doctors.

As for patient outcomes, I'd love to see a study of them for the roughly 15% of residents that have a union and very modest work place improvements, compared to outcomes for the rest of residents. You're right, many doctors do seem to "feel" the traditional method is superior, but I'd like to see hard data.

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uxp100 2757 days ago
I know I've seen some before, I think The Atlantic had an article about it in the past year.

I found this paper: http://www.acgme.org/Portals/0/PDFs/Position%20Papers/Commit...

It's citations have some hard data. Maybe the most interesting part for me was this:

"There exists instead a widespread belief that physicians can be trained to defy the biology of sleep and that safeguards are in place so that patients and residents are not harmed by work schedules that are unheard of in any other workplace, let alone a hospital. That belief is most evident today in the FIRST and iCOMPARE studies that set out to prove that there is no difference in patient outcomes from residents who work 16 or 30 hour shifts. The principal investigators were so convinced that no harm would come of these experiments that they determined it wasn’t necessary to obtain informed consent from either patients or residents in the hospitals where the studies were conducted. This determination has been widely disputed and is now under investigation by the Office of Human Research Protections."

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