Limited resident work hours demand new sense of professionalism

The introduction of strict limits to resident work hours calls for a new approach to surgical education and patient care, according to an article in the March issue of Archives of Surgery, one of the Journal of the American Medical Association/Archives journals.

The article, Professionalism and the Shift Mentality, says the work hour limits and other changes in health care mean that surgery and other medical disciplines have moved from the traditional, individual-provider responsibility for patient care to a team approach. This shift in the doctor/patient relationship challenges the residents' sense of professionalism and the continuity of care.

Carlos Pellegrini, professor and Henry N. Harkins chair of surgery; Erik Van Eaton, surgery fellow; and Karen Horvath, associate professor of surgery wrote the article. The authors propose that residents be taught professionalism within the context of a team caring for patients.

To reconcile the physician's obligation to ensure continuity of care with limited work hours, the authors suggest that professionalism be taught differently. They also suggest that surgical education include: a clear understanding of resident responsibilities; a new way for residents to approach their responsibility; and educational programs and patient care systems that enhance communication and make a team approach to care easier to practice.

The article is available at the Archives of Surgery Web site, http://www.archsurg.com