But a new study published in JAMA Surgery actually surveyed the people most affected by the work hour rules – the residents themselves.  In a study of over 1000 surgical residents in training, 2/3 of them disapproved of the restrictions on the shifts of the most junior trainee surgeons, first-year surgical interns, to 16 hours and caps on the shifts of the remaining residents at 28 hours. The rules were put into place in order to improve patient care as well as the residents’ education and quality of life.  The results of the survey may say otherwise.

40% of respondents claimed that patient care got worse (only 10% reported improvements in patient care), 55% said that their own education had suffered, and nearly 70% reported their was less focus on preparing them to take on a more senior roles. About half of the residents said their work schedules were worse after the change, and about 22% said they were getting less rest despite the limits on work hours.  Most striking, nearly 70% of respondents said they were not following the new requirements in on way or another, either by falsifying hours or under reporting.

For the most part, doctors are a dedicated group of professionals.  I know I’m biased here, but I would argue that those who choose to undergo 5 years of surgical training are by definition a dedicated group, who enjoy learning and don’t like to abandon their patients.  The findings of this study, if anything, prove that residents have a lot of work to do and don’t like missing out on learning opportunities.  If the very people who are subjected to the rules are telling us that the rules are making things worse and not better… what exactly are we doing here?

EHR supporters claim that electronic records have the potential to improve the quality and safety of care as well as provide ample data for tailoring and customizing treatment for patients with chronic diseases.  But doctors aren’t well known for change, and many are hesitant to change long-standing practice.  Some report that typing on a computer takes away from the doctor-patient relationship.

The direction of EHR in the United States is clear, as incentives from the federal government have largely paved the way.

Never be so faithful to your plan that you are unwilling to consider the unexpected

- Senator Elizabeth Warren to the 2013 graduating class of Framingham State University

Give more than expected; love more than seems wise; serve more than appears necessary; help more than is asked.

With nearly 6,700 graduates, Boston University’s commencement ceremony is the city’s largest each year.  On such a joyous occasion, President Robert Brown stopped and reflected on what has been a trying year for the university.  Since last spring, Boston University has lost 11 students in a series of tragedies including an apartment fire, a biking accident, and the Boston Marathon bombings.  Each of these tragedies struck hard for a large urban school that often lacks the sense of community feeling that is far more common for smaller colleges and universities with a backdrop of rolling green hills and ivy-covered halls.

I’m incredibly proud of my alma mater for awarding posthumous degrees to two of those students who would have graduated this year.  A world class move Boston University; classy indeed.

“Yeah I know, I totally paused…”

“No… you did the South End shuffle.”

The arc of the moral universe is long, but it bends toward justice