My how things have changed since the dinasaur days when I was a resident(early 80’s)….there are new rules on hours a resident may work, and with electronic medical records, many hours are spent in front of the computer: half of the residents day, in fact. The Law of Unintended Consequences comes into effect: By limiting residnet hours, they do not learn nearly as much or as well; medicine training is experiential, you cannot substitute for sitting with a patient and talking. Residents now spend only 8 minutes per patient, with much more time “documenting into a computer”. (Documenting for what, so they can defend themselves in court 2 years later, how dumb…but I digress..)……The result of limited time with patients is the legions of new doctors can’t work out difficult problmes as well when you are sick; they don’t feel the connection to you(it is more a 9 to 4 mentality, after all, they must be at every game and practice of their kids), and overall we have relatively crummy medical care. And expensive. Great. And, as an aside, I have noticed that the headache training that new residents recieve has gone downhill, to the point where most new neurologists barely recognize cluster headaches, let alone are able to treat them…….Larry “on my soapbox” Robbins,M.D.

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