Reducing Work Hours for Resident Physicians
New findings, published in a recent edition of the online journal BMC Medicine, indicate that Americans strongly favor tighter regulation of the number of consecutive hours that resident physicians are allowed to work and overwhelmingly disapprove of shifts lasting longer than 24 hours, which are currently required by teaching hospitals. Only 1 percent of general public supports widespread practice of resident physicians working shifts longer than 24 hours, according to a recent research. This is the first systematic study of public perceptions of resident work hours.
This study comes as the Accreditation Council for Graduate Medical Education (ACGME), the organization that oversees physician training in the United States, prepares to make public its proposed new guidelines governing resident work hours.
Patients are very concerned about being cared for by a fatigued physician. Four-fifths of the general public believes that reducing resident work hours would reduce medical errors, the study found. Patient safety groups have formed a coalition to bring light to the issue of resident hour reform and created a website, www.WakeUpDoctor.org, to raise public awareness of the problem.
Fatigue is common among medical residents, as are medical errors, the researchers noted. "One of five resident physicians admits to making a fatigue-related error that has injured a patient, and one in 20 admits to making a fatigue-related error that has resulted in the death of a patient," said Dr. Charles Czeisler, a senior author of the study and Baldino professor of sleep medicine at Harvard School of Medicine. "Working for 24 hours without sleep impairs performance to a degree that is comparable to being legally drunk. Patients have a right to be concerned for their safety when doctors work marathon 24-hour shifts. Reducing resident physician work hours is an effective way to improve patient safety."
"The finding that patients do not find it acceptable to be cared for by fatigued, poorly supervised residents should not come as a surprise," said Helen Haskell, founder of Mothers Against Medical Error, a coalition member. "The fact that the public is almost completely unaware of the actual working conditions of medical residents is symptomatic of the gulf in thinking between patients and those who are responsible for setting the standards for the residents who care for patients."