Back on November 15 and 16, we blogged the problem of sleep deprivation for interning doctors and the potential negative impact on the treatment of injured workers. Interns are routinely on call for over 30 consecutive hours. Once beyond about 16 hours, they are more prone to making mistakes. Given that these sleep deprived doctors staff our emergency rooms, which are the first line of defense for injured workers, the potential for harm in the treatment provided to these workers is substantial.
A new article in the New England Journal of Medicine indicates that the danger does not end when the seemingly interminable shift is finally over. Doctors who drive home after working these extended shifts are twice as likely to have accidents. Thus, their sleep deprivation, a product of a medical system that exploits the services of some of our most talented citizens, poses a risk to patients, to these highly trained and valued people themselves, and to the general public.
Liz Kowalczyk, author of a related article in the Boston Globe, quotes Dr. Charles Czeiler, chief of the division of sleep medicine at Brigham and Women’s Hospital: “That’s akin to letting someone get behind the wheel when you know they’re drunk. Yet hospitals are forcing interns to work these shifts.”
Some steps have already been taken to reduce the number of hours interns are allowed to work. Nonetheless, extended shifts are still sanctioned by the Accreditation Council for Graduate Medical Education. Sleep deprivation (and low wages) appear to be a “rite of passage” into the ultimately prestigious and lucrative medical field. The working conditions of our young doctors are nothing less than scandalous. There is a powerful correlation between sleep deprivation and poor performance. If we are serious about providing good health care in this country, and if we are serious about providing decent working conditions for our valued medical professsionals-in-training, then we will find a way to put an end to the barbarous “on call” practices of our teaching hospitals.
