Why Surgeons Struggle with Work-Hour Reforms
Why Surgeons Struggle with Work-Hour Reforms

Author: James E. Coverdill

Publisher: Vanderbilt University Press

Published: 2021-01-15

Total Pages: 285

ISBN-13: 0826501079

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On July 1, 2003, work-hour reforms were enacted nationally for the roughly 129,000 resident physicians in the United States. The reforms limit weekly work hours (a maximum of eighty per week) and in-hospital call (no more than once every three nights), mandate days free of clinical and educational obligations (one day in seven), and regulate other aspects of resident work life. Why Surgeons Struggle with Work-Hour Reforms focuses on general surgeons, a historically long-hour specialty, who fiercely opposed the reforms and are among the least compliant. Why do surgeons struggle with the reforms? Why do they continue to work long hours and view the act of doing so as reasonable if not quintessentially professional? Although the analysis is situated in the growing scientific literature on the consequences of fatigue, the authors do not adjudicate between the claims of surgeons and reform advocates about the effects of long work hours on patient or provider safety. Rather, the aim is to explore and explain how aspects of the occupational culture of surgeons and the social organization of surgical training and practice interlock to impede the reforms.

Challenging Operations
Challenging Operations

Author: Katherine C. Kellogg

Publisher: University of Chicago Press

Published: 2011-07-30

Total Pages: 244

ISBN-13: 0226430030

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In 2003, in the face of errors and accidents caused by medical and surgical trainees, the American Council of Graduate Medical Education mandated a reduction in resident work hours to eighty per week. Over the course of two and a half years spent observing residents and staff surgeons trying to implement this new regulation, Katherine C. Kellogg discovered that resistance to it was both strong and successful—in fact, two of the three hospitals she studied failed to make the change. Challenging Operations takes up the apparent paradox of medical professionals resisting reforms designed to help them and their patients. Through vivid anecdotes, interviews, and incisive observation and analysis, Kellogg shows the complex ways that institutional reforms spark resistance when they challenge long-standing beliefs, roles, and systems of authority. At a time when numerous policies have been enacted to address the nation’s soaring medical costs, uneven access to care, and shortage of primary-care physicians, Challenging Operations sheds new light on the difficulty of implementing reforms and offers concrete recommendations for effectively meeting that challenge.

Challenging Operations
Challenging Operations

Author: Katherine C. Kellogg

Publisher: University of Chicago Press

Published: 2011-07-05

Total Pages: 244

ISBN-13: 0226430014

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In 2003, in the face of errors and accidents caused by medical and surgical trainees, the American Council of Graduate Medical Education mandated a reduction in resident work hours to eighty per week. Over the course of two and a half years spent observing residents and staff surgeons trying to implement this new regulation, Katherine C. Kellogg discovered that resistance to it was both strong and successful—in fact, two of the three hospitals she studied failed to make the change. Challenging Operations takes up the apparent paradox of medical professionals resisting reforms designed to help them and their patients. Through vivid anecdotes, interviews, and incisive observation and analysis, Kellogg shows the complex ways that institutional reforms spark resistance when they challenge long-standing beliefs, roles, and systems of authority. At a time when numerous policies have been enacted to address the nation’s soaring medical costs, uneven access to care, and shortage of primary-care physicians, Challenging Operations sheds new light on the difficulty of implementing reforms and offers concrete recommendations for effectively meeting that challenge.

Cincinnati Magazine
Cincinnati Magazine

Author:

Publisher:

Published: 2004-11

Total Pages: 278

ISBN-13:

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Cincinnati Magazine taps into the DNA of the city, exploring shopping, dining, living, and culture and giving readers a ringside seat on the issues shaping the region.

Medicine and Politics in Colonial Peru
Medicine and Politics in Colonial Peru

Author: Adam Warren

Publisher: University of Pittsburgh Pre

Published: 2010-10-24

Total Pages: 306

ISBN-13: 0822973871

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By the end of the eighteenth century, Peru had witnessed the decline of its once-thriving silver industry and had barely begun to recover from massive population losses due to smallpox and other diseases. At the time, it was widely believed that economic salvation was contingent upon increasing the labor force and maintaining as many healthy workers as possible. In Medicine and Politics in Colonial Peru, Adam Warren presents a groundbreaking study of the primacy placed on medical care to generate population growth during this era. The Bourbon reforms of the eighteenth century shaped many of the political, economic, and social interests of Spain and its colonies. In Peru, local elites saw the reforms as an opportunity to positively transform society and its conceptions of medicine and medical institutions in the name of the Crown. Creole physicians, in particular, took advantage of Bourbon reforms to wrest control of medical treatment away from the Catholic Church, establish their own medical expertise, and create a new, secular medical culture. They asserted their new influence by treating smallpox and leprosy, by reforming medical education, and by introducing hygienic routines into local funeral rites, among other practices. Later, during the early years of independence, government officials began to usurp the power of physicians and shifted control of medical care back to the church. Creole doctors, without the support of the empire, lost much of their influence, and medical reforms ground to a halt. As Warren’s study reveals, despite falling in and out of political favor, Bourbon reforms and creole physicians were instrumental to the founding of modern medicine in Peru, and their influence can still be felt today.

Humanizing Healthcare Reforms
Humanizing Healthcare Reforms

Author: Gerald Arbuckle

Publisher: Jessica Kingsley Publishers

Published: 2012-10-15

Total Pages: 274

ISBN-13: 0857006584

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Looking at the current turmoil facing contemporary healthcare systems worldwide, resulting from relentless imposition of financially-based performance indicators, the author argues that a return to a values-based approach to healthcare will create positive transformation. Writing from the fresh perspective of social anthropology, the author takes a highly pragmatic approach to practice, emphasizing the importance of values such as compassion, solidarity and social justice. He suggests that without being able clearly to identify the values and goals that unite their members, healthcare organizations are unlikely to be able to meet the demands of the constant and varied pressures they face, and explains how individuals at every level in healthcare can contribute in practical ways to positive change within their organizations. This much-needed and very accessible book will be essential reading for anyone interested in a better approach to healthcare reform, from clinicians and nurses, to managers and policy makers, as well as the interested reader.