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Commentary
December 01, 2007

Patient Safety and SurgeonsWhy the Resistance?

Arch Surg. 2007;142(12):1127-1128. doi:10.1001/archsurg.142.12.1127

Many surgeons older than 55 years probably did most of their training under the system originated by Dr William Halsted at The Johns Hopkins Hospital at the beginning of the last century. This system was propagated by the numerous chairs and division chiefs trained by his successor, Dr Alfred Blalock. What we remember most was the call schedule: 36 hours on and 12 hours off forever. While that system certainly instilled discipline into us, it was conceived under delusions of grandeur of the invincibility of surgical residents, which totally ignored the frailties of the human body and mind. I am sure that every surgeon who trained under those circumstances can provide a litany of near misses and actual errors made because of sheer exhaustion. Yet I still hear colleagues of that ilk today decrying the new work-hour restrictions and declaring that this will spell the end of well-trained surgeons.

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