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PAs and Rest

Published December 15, 2008 2:55 PM by Terri Schaefer
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The New York Times today published a letter to the editor about physician assistants from Jason Adelman, an internist who is associate director of medicine for physician assistants at Montefiore Medical Center, as well as the patient safety officer.

He was replying to an editorial about a report from the Institute of Medicine that urged that residents work no more than 16 hours straight during an 80-hour week.

To the Editor:

While a good start, the regulations that put in place the 80-hour workweek for residents resulted in patient-care responsibilities being shifted to physician assistants. Under current laws, physician assistants have no equivalent regulations.

Making matters worse, it is common practice for physician assistants to work back-to-back shifts at different hospitals, thus making it difficult to track their hours.

Congress should demand comprehensive regulations to ensure that all front-line health care providers are well rested, including physician assistants, nurses and pharmacists. Perhaps then we will begin to see a significant improvement in patient safety.

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posted by Terri Schaefer

1 comments
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THIS PERSON HAS HIT THE NAIL ON THE PROVERBIAL HEAD. WHETHER WE BE NON-PHYSICIN PROVIDERS, NURSES, EMT'S OR OTHER VALUABLE TECHNICIANS OR A PHYSICIAN OR RESIDENT---WE ARE ALL HELD TO A STANDARD. THAT STANDARD IS TO APPLY OUR KNOWLEDGE AND SKILLS SPEEDILY, APPROPRIATELY AND SAFELY REGARDLESS OF THE TIME OR HOUR.

I HAVE LEARNED FROM MANY YEARS OF PRACTICE THAT THIS IS AN ACCEPTABLE STANDARD BUT CAN BECOME HAMPERED BY EXCESSIVE HOURS IN MULTIPLE ENVIORNMENTS THAT CANNOT BE VERIFIED. I HAVE WORKED MANY YEARS IN EXCESS OF 100 HOURS A WEEK---IT WAS NOT FUN, IT WAS NEEDED TO PROVIDE FOR MY FAMILY, THE LAW PERMITTED IT BUT THE BIG QUESTION COMES DOWN TO ; DID EVERY PATIENT BECOME THE RECIPIENT OF MY MOST EXCELLENT AND JUDICIAL CARE?"

Many can argue that their excessive hours do not have a negative affect of their care of the patient. I offer one very tangible reply

1

Speak to a driver who has drank excessively and has triple the ETOH levels. He entered a car, thoufght he was perfectly fine or sober or maybe had a buzz. Drove into the day or night and became involved in a MVC. The outcome was a tragic loss of life, a permanent disability, a vegatative state, a broken family , a ruined personal career as well as runing the career of the victim or victims. and the effect that this has on the personal families.

There should be a cap on the amount of hours we work and it should be done in the early legislative processes of the Obama legislation.

Great Roundtable discussion.

Bob Blumm
Bob bLUMM December 18, 2008 7:15 AM

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