Dei'ah veDibur - Information & Insight

A Window into the Chareidi World

11 Tishrei 5766 - October 15, 2005 | Mordecai Plaut, director Published Weekly










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Home and Family

Your Medical Questions Answered!
by Joseph B. Leibman, MD

Director, Emergency Services, Bikur Cholim Hospital

Some non-medical issue that will affect your care — based on letters I received from readers. There has been controversy in the literature about the long hours that doctors put in. In my day we worked 36 hours straight and sometimes 80-90 hours a week. The reason for this bone- crushing schedule was the claim of continuity of care, which was felt to be the best for the patient and the best for teaching student physicians. However, this produced tired doctors who made mistakes and grew to be uncaring and insensitive.

Then Libby Zion came to an emergency department in New York City and was given two medications that were a fatal mix. Her father was not satisfied with getting money — he wanted change and the New York legislature was forthcoming. Now residents work less hours, but it is still a grueling schedule.

In Israel residents work very hard for 24 hours straight, but are guaranteed one day off a week and the day after being on call. Usually this amount of sleep is not enough. Now an article in JAMA noted that concentration fell in tired physicians until they acted like someone who drank alcohol. I am in favor of limiting these hours — pilots and truck drivers have limitations on their work schedules.

Dan Naveh, the Israeli Minister of Health, was interviewed and said that the state of our health care system is at an all-time low. Despite the agreement to add more money to the system, there remain problems with lack of hospital beds, medications that are not in the health basket cannot be bought by most patients because of the steep prices, there is a lack of personnel such as doctors and nurses, and violence against doctors. (I myself was a victim of such behavior.) Kupot Cholim are making all of us pay more out of the pocket.

Mr. Naveh is working on a plan to reverse this situation, but the political realities do not favor this — health is just not important enough. Mr. Naveh also complained that the extra violence is a result of the rising violence in the society as a whole. A sad commentary if you ask me. Write me in care of the Yated.

A message from GlaxoSmithKline, sponsor of this column. Avandia is an advanced diabetes treatment — when pills fail, there is still an answer besides daily shots of insulin. This medication has spawned a new group of drugs that work similarly. Avandia can make diabetes manageable.


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