You see, if hand-offs are of high quality, there is reason to believe they can increase, rather than decrease, the quality of care – and reduce, rather than increase, the frequency of errors. If hand-offs are well done, they provide an opportunity for two doctors to engage in a discussion of a patient’s case and learn from each other. Do you think that discussion will be more fruitful if the doctor passing the baton to her colleague is finishing a really long shift, or a shorter one? The doctor finishing the longer shift is mentally exhausted and just wants to get the heck out of the hospital and go home to sleep.

‘When a health reporter for a major news outlet gets something so completely and inexcusably wrong, I am beyond exasperated.’ What will it take for them to get the facts right?

Certainly if we are going to have hospital-based trainees working fewer hours overall, we have to recognize and deal with the consequences. Unless we want them to have to complete the same amount of work in fewer hours, we have to have more of them, and we have to have ways of limiting the quantity of work, not just the number of hours. And we are working diligently to accomplish that.

We also have to realize that if a doctor is in training for 5 years after medical school, and we say he cannot work more than 80 hours per week, he’s not going to get as much experience in those 5 years as someone who has worked 100 or 120 hours per week. There is a famous story in which the chairman of the department of surgery at a major medical school says that the disadvantage of being on call every other night is that you miss half the interesting cases. But I can tell you from my own experience as a trainee, and from many years as a teacher, that one does not learn well when one is not adequately rested. I have concluded that, in medical training, the concept of “quality time” is very real.

Part of my keen interest in this subject is that I care deeply about the future of my profession, and I want to make sure the training that future generations of doctors get is optimal for the acquisition of knowledge and skills. And part of it is paternalistic, in the sense that my current trainees are the same age as my children, and I care about their well-being as I would if they were my own.