Editorial: Breaks (March 2007)
Your editorial on breaks was very good, but breaks should be called "delays in patient care." I have been amazed at how much time is spent on breaks by nurses and physicians, and their lounges are the site of wasted time. This is time that could be spent in the care of the patient. The people who push for breaks are the same ones who would not want a nurse or doctor on a break if one of their family members was the patient. I have noticed how in the medical profession the commandment of "love your neighbor as yourself" has disappeared. Very few health professionals treat the patient as they would like to be treated. It is a sad state of medicine to see patient care take a back seat to breaks and social time. We can start following the Golden Rule by doing away with break rooms and lounges, which are also a source of poor health practices for those in the medical profession. This is where food is served for any occasion. Look at how many nurses and physicians are overweight after years of parties, conferences, and any occasion to eat at work. Let's get back to patient care and return to practicing the Golden Rule of loving your neighbor (or patient) as yourself, which I have done in my 20 years of practice. It has been my observation that physicians speak these words but do not put them into action, and quality patient care in America has disappeared.
Lawson P. McNary, Jr., MD Roanoke Rapids, NC
I enjoyed your editorial lamenting the practice of taking breaks and the inconvenience it inflicts on all of us at one time or another. You pointed out that surgeons do not take breaks during operations, but I wonder if perhaps we should. I can think of many times when I have paused during an operation, taking a moment or two to reflect on my next move. This practice was probably not noticed by those working with me, as they saw me examining the surgical site or rearranging retractors, but in fact I was taking a "break" to try to reach a best decision.
At other times I think a tired surgeon feels "rushed" and acts quickly instead of thoughtfully. Perhaps his (or her) taking a break at such a moment would be a break for the patient as well, allowing a mental regrouping and the formulation of a better thought-out plan of action. In this age of science-based medicine and surgery, perhaps there should be a scientific study of surgeons taking breaks, to see whether doing so benefits their patients. After all, a patient's well-being, rather than our personal comfort, is the only thing that matters.
Peyton Barnes, MD via E-mail
I have just taken a "break" between patients to tell you that I found your recent editorial especially cogent. There is little hope for bank tellers and cashiers. My concern is for tomorrow's patients and the care they will receive from today's house officers—the product of an 80-hour work week—once they have gone into practice and are no longer afforded the breaks (dual meaning) they currently experience. Once there is a critical mass of new graduates, perhaps we will have that revealed to us. As a side note, I also spent time in the United Kingdom, and I look back in astonishment at the pause that we took in the middle of a major abdominal case so that we might have a tea break with the anesthetist.
George Andros, MD Burbank, CA