Letter to the Editor

A reader weighs in on the seven on/seven off schedule.


I agree with Dr. Edward Ma that the seven on/seven off model of working as a hospitalist is not a good practice (“The scourge of seven on/seven off, “ ACP Hospitalist, May 2011). It does interfere with activities in which you would otherwise participate or attend. For this reason, as a locum tenens hospitalist, I often decline to work at hospitals that mandate a seven on/seven off schedule. As a result, I work the same number of shifts during the month as my colleagues, but I am able to enjoy activities outside the scope of medicine.

I strongly disagree with Dr. Ma, however, when he states that quality of care decreases with a busy schedule. There is nothing wrong with working a 12-hour shift, or seeing a patient at 5 p.m. The doctor who is “rushing with patients and their family members because we have so many other acutely ill patients” needs to re-evaluate his or her care; if needed, discuss the census with the hospital and the medical director. Rushing through patients has no correlation with a seven on/seven off schedule.

Hospitalists as a group are growing professionally. Each hospital and health care system needs to evaluate its staffing issues individually, including lifestyle accommodations, as the profession and health care both change.

—Brenda Jacobsen, DO, ACP Member, Pensacola, Fla.