Night Call

What do you think about these two posts that mention diametrically opposite perspectives on night call that were published within the last few days?

On September 7, 2011, NPR posted a story about a trauma and burn surgeon named James Jeng, who was on duty at Washington Hospital Center on September 11, 2001. He cared for a number of seriously burned victims from the Pentagon. In discussing the intensity of the post-burn care of these patients, he said this:

I had fallen into an automatic rhythm of 36 hours on, 12 off in-house duty. Every other night, then, I would get home to be with my family.

This, of course, is against all the new rules but somehow Dr. Jeng and the patients got through it despite the potential detrimental effects of “decision fatigue” and sleep deprivation.

On September 3, 2011, the following from M. Schoen, MD appeared on Sermo, a website devoted to physician issues:

In my group most of the new docs joining in the past couple of years are refusing to take internal medicine night call. These are both docs who are subspecialists (but who also practice medicine) and docs who are only internists. Meanwhile the bulk of the night call is being taken by the older docs (of whom 7 of the 25 or so docs are over 60). The group refuses to consider what will happen in the future when there will be no one to do night call. Is it common for groups to allow this? And what will happen down the road? 

This has attracted 286 comments with most of them deploring the situation.

So where is this all going? I think I know, and it’s not a good place.