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1 in 5 Hospital Docs Reports 'Unsafe' Workloads: Study
Date:1/29/2013

have come together to put the squeeze on already busy doctors. First of all are new limits placed on the hours that resident physicians (new doctors in training) can work, and some states have also passed laws that seek to fine-tune the nurses' working environment.

Although well-intentioned, these measures often lead to more work for doctors working in hospitals, Michtalik said.

Other factors are conspiring to increase physician workloads. The aging of the patient population and the complex nature of chronic diseases, as well as recent changes to the health care system may make this situation worse before it gets better, Michtalik said.

"The type of patients that come in through the emergency room tend to be more complex," he noted. "The straightforward ones are usually treated by their primary-care doctor as outpatients."

There is some truth to the findings, said Dr. Prakash Karki, co-director of a program at Union Hospital in Terre Haute, Ind., that is aimed at helping doctors working at the hospital.

"Our workload is changing and becoming more challenging," he said. Many subspecialists are doing less in-hospital work due to financial issues, which results in more responsibility for hospital-based physicians.

"We are becoming the jacks-of-all-trades," Karki said. What's more, "patients are older and coming to the hospital with more and more problems," he said. "A simple pneumonia patient may be out in three or four days, but we have patients with complications and infections that are resistant to antibiotics."

As far as how many patients per shift is too many, the new study may have set the bar too low, he said. "Fifteen patients is an easy day for us," Karki said. "We have some really busy days."

He agreed that these conditions could result in medical mistakes and preventable errors, including unnecessary patient deaths. The solution, Karki said, is that "we need more [hospital-based doctors] and legislation to he
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