We often hear about the dangers of operating a motor vehicle while sleepy. Some studies have drawn strong comparisons to the physiological impact of drowsiness to intoxication.
The risk seems especially acute when one is engaged in an activity where split-second choices and reactions could make the difference between life and death. With this in mind, it’s no wonder that practicing medicine while overtired is fast becoming recognized as equally dangerous.
Our New York City medical malpractice attorneys note a recent article in The New York Times Well Blog by Dr. Pauline W. Chen, detailing the extreme demands placed on new resident and interning physicians. These grueling schedules mean that, inevitably, residents routinely suffer extreme fatigue, which too often results in errors, oversights and misdiagnoses.
Chen recalls that during her days in surgical residency, two of her peers were fired. That left four residents to cover two hospitals and the work of six residents. They would each have to work every other night for the next 365 days to make it work. In one case, the group tried to swing 60-hour “power shifts” every other weekend so that the others could have at least one 24-hour stretch with a break.
Recently, the Accreditation Council for Graduate Medical Education, which accredits residency programs in the U.S., has been systematically reducing the number of hours that doctors-in-training can work. The most recent update, which was passed in 2011, holds that young doctors are allowed to work no more than 16-hours at a stretch.
But this has led to additional problems.
In order to try to cope with these new guidelines, many residency programs tried to get creative with scheduling by overlapping shifts where doctors who were leaving would “sign out” patients to the following shift. This leaves patient care disjointed. Other programs have implemented a “night float” system in which a resident would handle the work of a dozen interns in overnight shifts. This has inevitably led to problems.
But even worse: These doctors-in-training aren’t apparently getting any more sleep than before. A study published in March by the American Medical Association revealed that despite the decrease in duty hours, the odd schedules mean interns still aren’t getting enough sleep, many of them are unhappy and they are more concerned than ever about the possibility of medical errors.
The accreditation council has plans to review these findings, but it appears the bigger problem is the issue of overwork, due to a lack of doctors and an increase in demand. She said it would be as if you told a commercial pilot she had to reduce her hours in the air, but she would also somehow have to make 50 percent more flights.
It’s nothing short of impossible. The same principal applies for new doctors.
In the end, what suffers is the quality of patient care.
Chen proposes that the only way to lighten workloads – which will ultimately reduce new doctor fatigue – is to devote funding to increase the number of doctors-in-training and to find ways to reduce their workloads.
The Law Offices of Nicholas Rose, PLLC offers free consultations. Call 1-877-313-7673.
The Impossible Workload for Doctors in Training, April 18, 2013, By Dr. Pauline W. Chen, The New York Times
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