Literature DB >> 1604361

Does the current use of junior doctors in the United Kingdom affect the quality of medical care?

M McKee1, N Black.   

Abstract

Current proposals in the U.K. envisage a reduction in both junior staff numbers and the hours which they work. The proponents of change argue that this will improve patient care, although there are also opposing arguments, based mainly on the need to maintain continuity of care and ensure juniors gain sufficient clinical experience. By means of a literature review and interviews with junior doctors, this paper examines the effect of the existing system of hospital medical staffing on quality of care. There is evidence that the existing system reduces the quality of care, principally through mistakes associated with inadequate supervision, and lowered humanity of care due to tiredness. The training value of night-time and weekend work is low, and many doctors find it unsatisfying. In contrast, many doctors value providing continuity of care and a few appreciate the opportunity to gain unsupervised experience. Overall, the disadvantages of the existing system outweight the advantages, and change is required to improve the quality of care. There are, however, several obstacles to change, and there are doubts about the extent to which the current proposals will be implemented.

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Year:  1992        PMID: 1604361     DOI: 10.1016/0277-9536(92)90210-h

Source DB:  PubMed          Journal:  Soc Sci Med        ISSN: 0277-9536            Impact factor:   4.634


  14 in total

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3.  Junior hospital doctors' views on their training in the UK.

Authors:  B N Panayiotou; M D Fotherby
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4.  How are trainees in clinical microbiology and infectious diseases supervised in Europe? An international cross-sectional questionnaire survey by the Trainee Association of ESCMID.

Authors:  Zaira R Palacios-Baena; Thea Christine Zapf; David S Y Ong; Alberto E Maraolo; Caroline Rönnberg; Cansu Çimen; Céline Pulcini; Jesús Rodríguez-Baño; Maurizio Sanguinetti
Journal:  Eur J Clin Microbiol Infect Dis       Date:  2018-09-25       Impact factor: 3.267

Review 5.  Alternative models of organisation are needed.

Authors:  F Moss; M McNicol
Journal:  BMJ       Date:  1995-04-08

6.  Measuring progressive independence with the resident supervision index: theoretical approach.

Authors:  T Michael Kashner; John M Byrne; Steven S Henley; Richard M Golden; David C Aron; Grant W Cannon; Barbara K Chang; Stuart C Gilman; Gloria J Holland; Catherine P Kaminetzky; Sheri A Keitz; Elaine A Muchmore; Tetyana K Kashner; Annie B Wicker
Journal:  J Grad Med Educ       Date:  2010-03

7.  Measuring progressive independence with the resident supervision index: empirical approach.

Authors:  T Michael Kashner; John M Byrne; Barbara K Chang; Steven S Henley; Richard M Golden; David C Aron; Grant W Cannon; Stuart C Gilman; Gloria J Holland; Catherine P Kaminetzky; Sheri A Keitz; Elaine A Muchmore; Tetyana K Kashner; Annie B Wicker
Journal:  J Grad Med Educ       Date:  2010-03

8.  Individual and organizational predictors of depression in general practitioners.

Authors:  J Firth-Cozens
Journal:  Br J Gen Pract       Date:  1998-10       Impact factor: 5.386

9.  Weekend versus weekday admission and mortality after acute pulmonary embolism.

Authors:  Drahomir Aujesky; David Jiménez; Maria K Mor; Ming Geng; Michael J Fine; Said A Ibrahim
Journal:  Circulation       Date:  2009-02-09       Impact factor: 29.690

10.  The off-hour effect on trauma patients requiring subspecialty intervention at a community hospital in Japan: a retrospective cohort study.

Authors:  Yuko Ono; Tokiya Ishida; Yudai Iwasaki; Yutaka Kawakami; Ryota Inokuchi; Choichiro Tase; Kazuaki Shinohara
Journal:  Scand J Trauma Resusc Emerg Med       Date:  2015-02-10       Impact factor: 2.953

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