Recent comments in /f/philadelphia

phillyapple t1_j8ycj12 wrote

Reply to comment by [deleted] in Penn Medicine residents and fellows want a union, citing grueling workloads and 80-hour workweeks by nankles

Making $1M is pretty much unheard of unless you’re a neurosurgeon working insane hours. Your friend is definitely an anomaly. Paradoxically you get paid less in more desirable urban areas with higher COLs as a physician. So it’s true that if you’re fine with living in an area that has a physician shortage you can make really good money in a low COL area. I find a lot of meaning in my work and overall don’t regret my decision but these days if you’re going into medicine for the money, you’re gonna have a bad time.

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Glystopher t1_j8yc2wh wrote

Reply to Best CSA in the city? by Lolotopo

Holy shit CSA’s are expensive and I’d rather just buy based on what I’m cooking… me, after browsing Lancaster farms offers…

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ConfiaEnElProceso OP t1_j8ybxbj wrote

Reply to Lancaster Ave by Overbrook high by ConfiaEnElProceso

I drove today because it was pouring in the morning, but this would be utterly terrifying on my bike. I remember when some idiot knocked out ALL the traffic lights at Girard and 34th (the zoo intersection). It was the purest form of chaos I have ever seen.

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ForkBombGoBoom t1_j8ybps9 wrote

Reply to comment by ferrusmannusbannus in Penn Medicine residents and fellows want a union, citing grueling workloads and 80-hour workweeks by nankles

> New England Journal of Medicine > https://www.nejm.org/doi/full/10.1056/NEJMoa1900669

This study says: "Longer Shifts for Surgical Residents are Safe for Patients"

It does not say: "[Making residents work less hours for more money] ended in way worse patient care and more deaths. "

> Northwestern University > https://news.northwestern.edu/stories/2016/02/longer-shifts-surgical-residents-safe

This study says: "resident physicians who were randomly assigned to schedules that eliminated extended shifts made more serious errors than resident physicians assigned to schedules with extended shifts, although the effect varied by site." However, it adds a big caveat: "The number of ICU patients cared for by each resident physician was higher during schedules that eliminated extended shifts." Additionally, the shorter shifts could still be 16 hours, and there was no data about total hours worked in a week, just about the length of a single shift.

It does not say: "[Making residents work less hours per week or for more money] ended in way worse patient care and more deaths. "

> Jama Study on Handover Mortality > https://jamanetwork.com/journals/jama/fullarticle/2589342

This study says: "End-of-rotation transitions may introduce risk in internal medicine inpatient care."

It does not say: "[Making residents work less hours per week or for more money] ended in way worse patient care and more deaths. "

> Canadian Medical Association > https://www.sciencedaily.com/releases/2015/02/150209122838.htm

This study says: "Shorter duty hours for medical residents, although marginally better for residents themselves, may result in worse patient care, according to a randomized trial assessing resident duty hour schedules in the intensive care unit."

This is the closest to your argument, but again, it looks at the length of individual shifts, not total hours worked in a week or month, which may have more of an impact.

Until we see a few studies showing that sustained 40 hour workweeks with 8 hour work days are inferior in patient outcome, I think these are all just bullshit.

And even then, the issue is wellbeing of the residents. It's not all about the patients. My workplace does better if I work 100 hours a week; I do not.

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