David: Surgeon, Michigan
Residents cannot work more than 80 hours a week. When I was training years ago, there was no such law. Sometimes that meant not sleeping, literally, for days on end. So it wasn't unusual for me when I was in my late 20s and early 30s to be working 110, 112 hours a week. It was regarded like a badge of courage, and if you wanted to succeed, you just had to do it. You had to look forward to the time when, as an attending surgeon, you wouldn't have to work that hard, because you'd have the new residents do all of the extra work.
Well, that didn't last very long, because I had been an attending surgeon for only a very short while when these laws started to become real. Now the residents have to leave the premises and go home, and if they don't, then the accreditation body could close down that whole residency. It became obvious after a while that the people who were catching up on the slack were us, the attendings. That means a guy like me—I'm 67 and still working full-time. Guys like me now have to work just like we did when we were residents. When the residents have to go home and something needs to be written up or the patient needs to be seen in the middle of the night, the person who has to do that is me.
I work four days in a row, 24/7. By the time 96 hours is over, there isn't a lot of energy left for anything. That doesn't mean that I can stop taking care of patients. That means if I get called because somebody needs a prescription, or somebody has a complication from an operation I've done a few days previously, then I can't say, "Oh, let's get the resident."
I'm stretched so thin that I can't really give all of my attention to places that I really want to, because I'm too tired, because I've got too many patients to see. That's not just me. This is happening all over the place.