Can’t make doctors work over 12 hrs, hospitals told

The Delhi government has issued a circular restricting duty hours of resident doctors in all hospitals in the city to not more than 12 hours per shift per day. While in theory and in the rulebook of foreign accreditation agencies this is the norm, in practice it was never followed with resident doctors often forced to do back-to-back shifts, sometimes clocking up to 36 hours without a break.

In the circular issued on March 16, Director (hospital services) Dr Sanjay Agrawal wrote: “All director/medical superintendents and heads of clinical departments of hospitals/institutions/departments are advised that in case resident doctors are assigned continuous duties across multiple shifts in their hospitals/institutions/departments, then this practice must stop forthwith and duty rosters for resident doctors are prepared in a way that they are out on clinical duties not exceeding 12 hours in a shift in a day.”

Longer durations of clinical duties can only be sanctioned by the director or medical superintendent of the hospital but even in such exceptional cases, the total duration ofthe shift cannot exceed 17 hours, the circular specifies. In all such cases, the concerned authority would have to inform the secretary (health and family welfare) in the government of Delhi through email.

“Doctors routinely work 36-hour shifts twice, sometimes even thrice a week. As a postgraduate student, we often clock up to 100-120 hours in the hospital. This is insane in a high-precision vocation like medicine because fatigue would inevitably take a toll on your clinical judgement, your ability to concentrate and in case of surgeons especially, mere physical ability. It is a violation that has gone on for too long,” a senior doctor at Maulana Azad Medical College said, on condition of anonymity.

While hospitals in both the private and public sectors are still working out schedules to follow the new guidelines, there are some though who feel that not mentioning the maximum number of work hours per week was the government’s sleight of hand, so as not to provoke a debate on the ticklish issue of manpower shortage in hospitals.

“While specifying shifts is certainly an improvement, a better way to do this would have been to lay down that like every other worker in the country, a doctor will not work more than 40 hours. They did not do that because the moment that is specified, there would be questions about the number of staff members in the hospital. There, the government may find itself in a spot even worse than in private.

What this may essentially do for doctors is to force them to work without a weekly off,” another doctor at a Delhi government hospital said.

source : http://indianexpress.com/article/cities/delhi/cant-make-doctors-work-over-12-hrs-hospitals-told/