Forty Years And Medicine Still Has Not Changed

fatigue.jpgToday’s Los Angeles Times carries an op-ed co-authored by Dr. Lucian Leape of Harvard’s School of Public Health on the topic of resident fatigue.
July marks the month that young doctors begin their residencies at teaching hospitals across the country.
This month also marks the fortieth anniversary of a landmark article published in The New England Journal of Medicine that showed for the first time how much fatigue affects a doctor’s performance. The landmark article showed that sleep-deprived residents made twice as many errors reading electrocardiograms as well-rested residents.
Yet despite being aware, for nearly half a century now, that sleep-deprived residents were endangering patients, the medical community has done very little to remedy the problem.
In recent years, first-year residents have had their shifts capped at sixteen hours – a step in accordance with sleep science. But hospitals can force second- and third-year residents to work shifts of up to twenty-eight hours with little or no sleep.
Such policies are contrary to sleep science research, which demonstrates that human performance falls off a cliff after about sixteen hours of wakefulness.
Teaching hospitals, however, continue to have residents work long hours because the low-salaried residents are lucrative cash cows for the hospitals.
For more on this issue, check out last July’s blog post on the “July Effect.”

This blog in maintained by the Boston medical malpractice lawyers at The Law Office of Alan H. Crede, P.C.