White (Coat) Lies: Bending the Truth to Stay Faithful to Patients

Duty hour policies were originally implemented with the goal of protecting both resident physicians and patients. The policies were based on literature demonstrating that long shift lengths and absence of workhour regulations were dangerous to resident physicians and to the patients they care for (Landrigan et al. 2004; Nasca, Day, and Amis 2010; Accreditation Council for Graduate Medical Education [ACGME] n.d. ). However, current policies regulating resident physicians’ duty hours have received significant criticism. Many have argued that these policies are, in fact, detrimental to both residents and patients (Drolet et al. 2013; Bilimoria et al. 2016). In an effort to address these concerns, alternative (more flexible) models of resident education have been developed and are currently being tested, most notably in the FIRST and iCOMPARE Trials (Bilimoria et al. 2016; iCOMPARE 2016). Dubov and colleagues (2016) join this debate with the assumption that current policies have had the unintended consequence of destroying the individual patient–provider relationship; a shift-work mentality has surfaced and resident physicians’ decision ownership has suffered.