In 2003, in the face of errors and accidents caused by medical and surgical trainees, the American Council of Graduate Medical Education mandated a reduction in resident work hours to eighty per week. Over the course of two and a half years spent observing residents and staff surgeons trying to implement this new regulation, Katherine C. Kellogg discovered that resistance to it was both strong and successful—in fact, two of the three hospitals she studied failed to make the change. Challenging Operations takes up the apparent paradox of medical professionals resisting reforms designed to help them and their patients. Through vivid anecdotes, interviews, and incisive observation and analysis, Kellogg shows the complex ways that institutional reforms spark resistance when they challenge long-standing beliefs, roles, and systems of authority.

At a time when numerous policies have been enacted to address the nation’s soaring medical costs, uneven access to care, and shortage of primary-care physicians, Challenging Operations sheds new light on the difficulty of implementing reforms and offers concrete recommendations for effectively meeting that challenge.

In a panoramic study that draws on diverse sources, Jerry A. Jacobs and Kathleen Gerson explain why and how time pressures have emerged and what we can do to alleviate them. In contrast to the conventional wisdom that all Americans are overworked, they show that time itself has become a form of social inequality that is dividing Americans in new ways—between the overworked and the underemployed, women and men, parents and non-parents. They piece together a compelling story of the increasing mismatch between our economic system and the needs of American families, sorting out important trends such as the rise of demanding jobs and the emergence of new pressures on dual earner families and single parents.Comparing American workers with their European peers, Jacobs and Gerson also find that policies that are simultaneously family-friendly and gender equitable are not fully realized in any of the countries they examine. As a consequence, they argue that the United States needs to forge a new set of solutions that offer American workers new ways to integrate work and family life.

"An extraordinarily informative scholarly history of the debate over working hours from 1920 to 1940." --New York Times Book Review For more than a century preceding the Great Depression, work hours were steadily reduced. Intellectuals, labor leaders, politicians, and workers saw this reduction in work as authentic progress and the resulting increase in leisure time as a cultural advance. Benjamin Hunnicutt examines the period from 1920 to 1940 during which the shorter hour movement ended and the drive for economic expansion through increased work took over. He traces the political, intellectual, and social dialogues that changed the American concept of progress from dreams of more leisure in which to pursue the higher things in life to an obsession with the importance of work and wage-earning. During the 1920s with the development of advertising, the "gospel of consumption" began to replace the goal of leisure time with a list of things to buy. Business, which increasingly viewed shorter hours as a threat to economic growth, persuaded the worker that more work brought more tangible rewards. The Great Depression shook the newly proclaimed gospel as well as everyone's faith in progress. Although work-sharing became a temporary solution to the shortage of jobs and massive unemployment, when faced with legislation that would limit the work week to thirty hours, Roosevelt and his New Deal advisors adopted the gospel of consumption's tests for progress and created more work by government action. The New Deal campaigned for the right to work a full time job--and won. "Work Without End presents a compelling history of the rise and fall of the 40-hour work week, explains bow Americans became trapped in a prison of work that allows little room for family, bobbies or civic participation and suggests bow they can free themselves from relentless overwork. [This book] is a sober reconsideration of a topic that is critical to America's future. It suggests that progress doesn't mean much if there is not time for love as well as work, and liberation is an empty achievement if the work it frees one to do is truly without end." --The Washington Post "Hunnicutt, with this excellent book, becomes the first United States historian to examine fully why this momentous change occurred." --The Journal of American History "Hunnicutt's achievement is to ask the questions, and to provide the first extended answer which takes in the full array of economic, social, and political forces behind the ‘end of shorter hours' in the crucial first half of the twentieth century." --Journal of Economic History "This thoroughly documented history [is] a valuable book well worth reading." --Libertarian Labor Review "This is an important book in the emerging debate about alternatives to full employment. Hunnicutt is a skilled historian who is on to an important issue, writes well, and can bring many different kinds of historical sources to bear on the problem." --Fred Block, University of Pennsylvania "Work Without End is a disturbing but impressive indictment of both big business and the New Deal program of Franklin D. Roosevelt.... Hunnicutt presents an unusual but persuasive description of a successful conspiracy to deprive American workers of their vision of a shorter-hours work week and the individual and societal liberation which would flow from it." --Labor Studies Journal