My heading isn’t really the greatest but I thought it would catch the eye of most quicker as it is really “out of the box”. I recently read an article on how intern doctors are the slaves of the state (Erasmus, 2012).
As a student physiotherapists we often work in clinics and hospitals in and around Cape Town where we interact with intern Doctors. During our journey on each rotation which is generally 5-6 weeks we seek to gain as much knowledge as possible, which in turn means asking doctors a lot of questions.
Occasionally I’ve asked a doctor a question and not really gotten an answer out of them or a response of sorry I cannot now etc.. After hearing that I used to think they could at least assist me somehow instead of blowing me off. My attitude towards them would instantly change and I would not ask them another question from that point on.
It’s only recently that I read the article about the hours that they work and I instantly felt terrible. I never once thought about what was going in that doctors life.
Owing to a chronic shortage of medical staff in South Africa, sleep-deprived medical interns and community service doctor’s work up to 200 hours of overtime per month under the state’s commuted overtime policy.
Only up to 80 actual overtime hours worked are paid; overtime in excess of 80 hours per month is unpaid. The corollary is that interns are assured by JUDASA (Junior Doctors Association of South Africa) that ‘no intern is to work more than 80 hours of commuted overtime per month. So doctors have to join the JUDASA for protection of their rights. They have to sign a contract for 2 years of internship whereby its non-negotiable. The non-negotiable aspect is clearly stated as well as if they break any part of the contract it would be terminated and further actions could be taken. Having said that I read further into the article whereby it stated the following:
South Africa has a chronic shortage of skilled medical staff. With too few doctors and nurses for the patient workload, they are grossly overworked. Interns rotate through training blocks of approximately 4 months each in various disciplines, during which they are routinely allocated 120 – 200 hours of overtime per month – up to four times that permitted by the Basic Conditions of Employment Act 75 of 1997 (BCEA), and more than double the number of overtime hours for which the state contracts to pay them.
Now if institutions can clearly break a contract with regards to overtime what could be done to insure safety of the doctors? Working those incredibly long hours should certainly have a major negative effect. The reason for my heading above is due to a study done whereby they tested the difference between driving while slightly over the limit and also driving with sleep deprivation. The results were that sleep deprivation was worse than driving slightly under the influence.
Lack of sleep strongly impairs human functioning, and leads to memory loss, attention deficit, negative mood changes, over-optimistic risk-taking, prolonged post-call recovery, road accidents, mistakes on duty and in surgery, adverse health conditions, and HIV needle-stick injuries.
Effects as such are extremely dangerous not only to their health but also to the patients that they see. After i read the entire article I began to re-think my situations with intern doctors. As i now have a better understanding of the things they go through i have a new found respect for them.
Below is a link to a really interesting article about a doctor in Tygerberg Hospital.
Philp R. Hospital hell. Sunday Times, 24 May 2009. http://www.netassets.co.za/article.aspx?id=1006006 (accessed 13 May 2012).
Erasmus, N. (2012). Slaves of the state – medical internship and community service in South Africa. The South African Medical Journal, Vol 102, No.8. Retrieved from The South African Medical Journal: http://www.samj.org.za/index.php/samj/article/view/5987/4343