[chrisseaton]

Those long shifts are there to protect patient safety - they reduce the number of dangerous handovers. Part of being a doctor or in something like the military is putting other people first rather than having a comfortable short day.

[gus_massa]

Handovers are dangerous, but making decisions that need your full attention after hard working 11:30 hours is also dangerous. And sometime doctors have even longer shifts.

It's an insane culture.

My guess is that it is easy to spot error in handovers (X didn't say/write this, Y didn't hear/read that). But errors due that you have worked 11:30 hours are more difficult to isolate.

[chrisseaton]

Why do you think the hospitals do long shifts then? Just for fun?

They don't do it for people who aren't doing handovers, like general practitioners who can work half-days just a couple of times a week if they want, or administrations. So we know it isn't inherent for doctors or for the staffing of the hospital. Only for those doing handovers...

[AlexCoventry]

> Why do you think the hospitals do long shifts then? Just for fun?

Because the culture of US medical training was initiated by a coke addict, and it's extremely conservative and slow-moving.

https://en.wikipedia.org/wiki/William_Stewart_Halsted

[chrisseaton]

But medical shifts are like this the world-over.

[AlexCoventry]

Why do you believe that?

https://en.wikipedia.org/wiki/Medical_resident_work_hours#EU...

[chrisseaton]

That’s exactly what I mean - cf

https://www.theguardian.com/society/2009/nov/05/nhs-confiden...

In the UK they always worked long shifts because it’s safer. They’re trying to stop them, and it’s less safe.

Why do you think the reason the UK has always worked long hours is due to a drug addiction in the US rather than experience in safety?

[michaelt]

Personally I don’t find “everyone is doing this so it must be rational” a very convincing argument. After all, maybe everyone else followed that same weak argument.

[chrisseaton]

But conversely how do you think everyone arrived at an unsafe practice particular to just these doctors who do handovers and no others? And why do you think they’re campaigning themselves to bring them back for safety in the UK?

[pessimizer]

All of these countries didn't independently discover medicine, and they do speak with each other i.e. they share a culture. Why do they all dress the same, why are so many addressed with a title in front of their names, and why do they all seem to refer to a lot of things in Latin?

We can choose to think that they independently arrived at an ideal state, but that's not reasonable.

[cimmanom]

What if handovers are dangerous in large part because the outgoing shift members are fatigued to the point of intoxication?

[chrisseaton]

Take this for example - from the Guardian, a very left-wing newspaper that is normally about as far from arguing for longer hours for works as you can possibly get.

https://www.theguardian.com/society/2009/nov/05/nhs-confiden...

> The report suggests the shorter working week is responsible for a lack of continuity in out-of-hours care

> shortening rota hours had led to more shift changes between medical teams and greater chances for mistakes to occur

> the early effects of the 48-hour European working time limit on surgeons and found that these new rotas had almost entirely removed adequate time for handover of sick patients

Also think about this - those doctors who don't do handovers, such as a dermatologist doing out-patient clinics, don't work long hours. Hospitals only do it where clinically required.