Concerns about patient safety at the hands of exhausted interns and first-year medical residents led to restrictions being placed on the number of hours they are permitted to work in their teaching hospitals.
Two studies found that reducing or limiting the number of hours they can work in a week to 80 hours and the length of individual shifts to 16-24 hours at one time for interns and residents, have not led to an significant improvements to patient safety by reducing medical malpractice.
On the other hand, the increased number of handoffs between doctors has not caused an increased number of doctor’s errors, as was predicted by critics of the restrictions.
One study was headed by a doctor from the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, examined the records of 2.8 million patients and found there was “no effect” on the risk of death within 30 days of their admission. They also found no change in the rate of re-admission.
Of course, this assumes that doctors were accurately reporting their hours, and that 80 hours is not inherently too many hours for a doctor to work. Nonetheless, some doctors feel that the there was “no justification” for the hour restrictions.
Because hands-offs between doctors are potentially dangerous to patients, how well the hospital is equipped to ensure that important issues are not confused or lost in the shuffle may be as important as how many hand-offs occur.
As medicine continues to be industrialized and subjected to a “production line” mindset, doctor’s errors, misdiagnosis and mistakes should be carefully analyzed to determine if they occurred because of systemic failure or individualized negligence.
Latimes.com, “Work hour limits for doctors in training don’t improve patient safety,” Karen Kaplan, December 9, 2014