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61 CARE DELIVERY Longer Surgical Resident Hours Don't Hinder Patient Care, Study Says By Max Green E xtending hours for surgical residents doesn't nega- tively affect patient care, according to a New England Journal of Medicine study. In fact, longer hours may improve patient recovery if surgical residents stay with pa- tients post-operation or are on hand to help stabilize them in critical situations. Researchers analyzed data from 117 residency programs across 151 hospitals and health systems and found those using more flexible duty hours for residents yielded no significant difference in residents' self-reported satisfaction, overall well-being, quality of training or patient outcomes for 10 metrics. The conclusions of the new study are a bit counterintuitive. Longer clinical hours are often associated with fatigue, burnout or slip-ups, and the issue has attracted regulatory attention. The Accreditation Council for Graduate Medical Education revised its policies around resident shifts twice, first in 2003 and again in 2011. The 2003 revision mandat- ed that residents work under 80 hours per week, including restrictions for minimum amount of time between shifts and caps on overnight shift length. The 2011 update decreased the acceptable shift length for residents and increased the amount of time they are required to take off between shifts. However, the authors suggest the real cause of errors in patient care occur during hand-offs, when a physician or medical staffer updates the incoming clinicians about the status of a patient. "In surgery, this more frequent turnover may compromise continuity of patient care, potentially jeopardize patient safe- ty and decrease the quality of resident education by forcing residents to leave at critical times, such as in the middle of an operation or while stabilizing a critically ill patient," said Karl Bilimoria, MD, director of the Surgical Outcomes and Quality Improvement Center at Northwestern University Feinberg School of Medicine in Chicago and co-author of the study. Greater flexibility in surgical resident works hours can pre- vent patient care disruptions without impacting outcomes or surgical education, the authors concluded. n Mythbusting the Modern MD: 4 Findings Fight Outdated Stereotypes of Physicians By Emily Rappleye T hough we oen say value-based care, increased pressure on compensation and a new regulatory environment will force physicians to adapt, and we don't always give them credit for changing. In fact, many long-standing stereotypes about physicians — espe- cially in regards to their attitudes toward physician preference items, financial relationships and practice priorities — are simply not true, according to a survey from Procured Health. Procured Health surveyed more than 100 electrophysiologists and orthopedic surgeons. e sample included employed and indepen- dent physicians, and physicians from an array of working environ- ments, from teaching hospitals to community hospitals. Here are the top survey findings — some of which may be surprising. 1. Physicians do not find vendors trustworthy. ough they may seem attached to certain vendors — physicians ranked their satisfaction with device representatives equal to that of de- partment chairs — many say this is because vendors have been the primary source of information on product and procedure innova- tions. Despite this, physicians generally mistrust device reps, and said in the survey they value peer-reviewed literature and patient complaints more than vendors when making product decisions. 2. Physicians are more flexible than they are given cred- it for, according to the survey. Many administrators feel the need to surrender to every request from physicians for devices, or they will simply leave. However, the survey found only 6.9 percent of re- spondents had ever le a hospital due to medical device restrictions. According to Procured Health, given the 13-year average tenure of the physicians surveyed, this percentage is minimal. 3. Employment is not an automatic path to engagement and collaboration. According to Procured Health, many healthcare administrators may feel changing financial relationships with physi- cians is enough to incentivize collaboration. e survey shows financial rewards are important, but they are not the top driver of satisfaction. 4. A well-run hospital is physicians' No. 1 priority. According to the survey, nine in 10 physicians feel efficient operations are very or extremely important. is ranked above clinical autonomy, work/life balance, hospital reputation and unrestricted access to devices. n