Interns' Schedules Shortchange Patients, Study Suggests
Only 12 percent of their day spent at bedsides
Friday, April 26, 2013
Researchers tracked 29 first-year medical interns at Baltimore's two large academic medical centers for three weeks during January 2012, for a total of nearly 900 hours, and found that the interns spent just 12 percent of their time examining and talking with patients.
Sixty-four percent of their time was spent on indirect patient care, such as placing orders, researching patient history and filling out electronic paperwork; 15 percent of their time was spent on educational activities, such as medical rounds; and 9 percent was spent on miscellaneous activities.
The interns spent nearly as much time (7 percent) walking as they did at patients' bedsides, according to the study, which was published online in the Journal of General Internal Medicine.
"One of the most important learning opportunities in residency is direct interaction with patients. Spending an average of eight minutes a day with each patient just doesn't seem like enough time to me," study leader Dr. Lauren Block, a clinical fellow in the division of general internal medicine at the Johns Hopkins University School of Medicine, said in a university news release.
Other doctors agree. "Most of us went into medicine because we love spending time with the patients. Our systems have squeezed this out of medical training," study senior author Dr. Leonard Feldman, a hospitalist at the Johns Hopkins Hospital, said in the news release.
The researchers said the amount of time interns spend with patients has decreased significantly since 2003, when hospitals were first required to limit consecutive working hours for interns. That initial limit was 30 hours, which was reduced to 16 hours in 2011.
With interns spending fewer hours in the hospital, it's important to implement measures to ensure that they spend enough time with patients, the experts said.
"As residency changes, we need to find ways to preserve the patient-doctor relationship," Block said. "Getting to know patients better can improve diagnoses and care and reduce medical errors."