Crosspost to sci.med sci.med.radiology sci.med.diseases.cancer
sci.med.nursing

http://www.theage.com.au/articles/2006/10/25/1161749190007.html

Hospital doctor worked 107-hour week, audit finds

Carol Nader
October 26, 2006

A DOCTOR who worked 107 hours in one week at a Victorian hospital is one
of many who are jeopardising their health because of extraordinarily long
hours on the job, according to a national audit of doctors.

In another case, a junior doctor working in an emergency department at a
regional Victorian hospital worked a 100-hour week, including one shift
that lasted 34 hours.

The results have again raised questions about whether there should be
mandatory limits on the number of hours doctors may work.

The Australian Medical Association, which released the Victorian results
of the survey to The Age, ahead of the release of the national results in
Canberra today, says the figures are evidence that a cultural problem
persists in hospitals.

More than 500 doctors across the country responded to the AMA's "safe
hours" survey, including 188 in Victoria. The audit tracked the hours
doctors worked in the week of May 8 to 14 this year.

The Age reported last month that two young doctors had committed suicide
in the past year, bringing the culture in which young doctors work under
scrutiny. But the results of the AMA survey show that it is not just young
doctors who are at risk.

Among the respondents to the survey, a regional Victoria trainee surgeon
reported working more than 70 hours a week, with 17 hours in one day, and
no days off over a three-week period. A senior Melbourne doctor worked two
consecutive weeks of more than 70 hours each, including a 17-hour day.

The Victorian results also show:
61 per cent of doctors work hours that place them at significant (45 per
cent) and higher (16 per cent) risk of fatigue.
The longest reported working week was 107 hours and the longest reported
shift was 37 hours.
The average weekly working hours for doctors in the higher risk category
was 77 hours.

38 per cent of Victorian surgical trainees were in the high-risk category,
compared with 17 per cent of trainees across all specialties.

When the AMA national and state presidents meet next week, they will
consider whether there should be a push for mandatory restrictions on
hours. National president Mukesh Haikerwal said the hours were
unacceptable for both doctors and patients, who did not want to be
operated on by doctors who were not completely alert. "I think we're going
to have to push hard now for some commitment from governments over and
above what's in the enterprise bargaining agreements, some commitment to
safe rostering and safe hours," he said. "We may need to see that's
mandated in due course."

Dr Haikerwal said when doctors worked at least 12 hours, they entered the
"significant risk" category. Once they worked 18 hours they were at high
risk of fatigue.

Ben Hart, spokesman for state Health Minister Bronwyn Pike, said the
Government had employed 1576 more doctors since coming to office. "We have
worked to take the pressure off by employing more people, but this is not
as simple as more doctors," he said. "This is a complex issue influenced
by a number of different factors, many of them cultural, and we consider
it a very important issue and will continue to discuss the matter with the
AMA."

Jack Warhaft, medical director of the Victorian Doctors Health Program,
said the survey results were disappointing. "This was the sort of work
environment that we took for granted a generation or two ago," he said.
"It's disappointing to see that it's still as bad as this in 2006 … What
other profession, I ask you, has a consultant surgeon or indeed any doctor
having to work half the night or all the night and then do a normal day's
work the next day?"

Dr Warhaft said workplace problems, including long hours, were a major
source of stress and anxiety disorders.

Any doctors in distress can call the Victorian Doctors Health Program for
assistance on 9495 6011.