Progressively limiting the number of hours that medical residents can work, in response to public concerns about errors arising from fatigue, may be causing more problems than the system was designed to address.
The latest mandate (2011) by the Accreditation Council for Graduate Medical Education allows medical interns to work no longer than 16 hours in a day. Residency programs that violate the restriction risk losing their accreditation.
But this limit on hours does not lower the workload of medical professionals at the same time; instead, interns are faced with covering the same amount of work as before in fewer hours. In response, some hospitals have adopted a “night float” system that means a resident just a year out of internship has to carry the work of as many as 12 interns at night, looking after more than 100 patients.
Contrary to expectations, studies have shown that interns have not been getting significantly more sleep and are also not happier nor are they studying more. Interns are spending less time in educational activities because the additional time required for such conferences and lectures would push them over the 16-hour limit.
“You can’t keep asking these young doctors to do more and more work in less time without affecting patient care,” said Dr. Lara Gotein, a pulmonary and critical care physician at Christus St. Vincent Regional Medical Center in Santa Fe, N.M. “Until we address the problem of overwork, we’re just playing a shell game.” Read the full article here:
Surprisingly, not permitting residents to work more than 16 hours in any given day is not improving patient safety and is not improving residents’ quality of life.
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