Professionalism and the Shift Mentality
How to Reconcile Patient Ownership With Limited Work Hours
Erik G. Van Eaton, MD;
Karen D. Horvath, MD;
Carlos A. Pellegrini, MD
Arch Surg. 2005;140:230-235.
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INTRODUCTION
The Halstedian tradition imbued the art of surgery with a deeply rooted sense of responsibility and a powerful work ethic. As apprentice surgeons, junior residents gained reputations for professionalism when they immersed themselves in patient care so deeply and for such long periods that they "owned" their patients. No detail of patient care was so trivial that it could escape the effective intern.
The introduction of strict limits on resident work hours brought many positive changes to training programs nationwide. An unintended consequence of this policy is the potential for the loss of "patient ownership" by trainees. Patient ownership is the philosophy that one knows everything about one’s patients and does everything for them. It is a central tenet of surgical professionalism dating back decades and is fundamental when facing critical patient care decisions. The shortened duty . . . [Full Text of this Article]
PATIENT OWNERSHIP
RESIDENT PROFESSIONALISM
THE CONFLICTED RESIDENT
BARRIERS TO RESOLUTION
THE NEW PROFESSIONALISM
TELL TRAINEES WHAT TO DO
GIVE TRAINEES THE TOOLS TO DO IT
Resource Management Communication Skills Better Ways to Organize Data Educational Benefits of Sign-Out Tools
SHOW THEM HOW
WHAT ABOUT EDUCATION?
CONCLUSIONS
AUTHOR INFORMATION
Author Affiliations: Department of Surgery, University of Washington, Seattle.
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