January 14, 2005

A study finds that sleepy doctors-in-training are as dangerous on the road as drunk drivers. Medical interns are routinely asked to work more than 24 hours in a shift (in the US and I believe the UK), and afterwards, hospitals allow interns to drive home, exhausted. Should the hospital be liable for any accidents the intern causes due to sleep deprivation?

We've all driven when we were too tired, and know it's dangerous. Studies compare the effects of "driving tired" to driving drunk, and different countries have started education campaigns to combat it. (Here is the UK, Australia and the US (a .pdf file).)

  • Yes.
  • oh my god. >24 hour shift? Are you serious??
  • The next time you're in the hospital with some serious injury or illness, consider that the person trying to keep you alive may have been awake for 30 straight hours. It's amazing that health care, of all professions, requires its workers to do something that is known to be deterimental to the health of the workers, as well as to patient safety (and, apparently, the safety of other drivers).
  • No, but the new doctors should be allowed to give anyone demanding so much from them a chilli enema. By force, if necessary.
  • 24 hours shifts? 48 hours in some cases for junior doctors in hospitals here in the UK. I'm not particularly bothered about them driving home - how they're in any frame of mind to make complex decisions is what worries me ...
  • I was under the impression that it was still standard for UK doctors to work 5pm on a friday night through to 9am on a monday morning. Theoretically, beds are available for them to sleep when they are not required to attend a patient, but there is no guarantee of a break.
  • >24 hour shift? Are you serious?? Last year, IIRC, the Singapore government made it illegal to let interns hold shifts of longer than 56 hours. Which means that they can still work up to 56 hours consecutively, and that before the law was placed, they were working more than that in a row. According to doctor friends, UK is pretty ok compared to US and Singapore.
  • Going wisdom (I've heard) is that if you need surgery, schedule for a Monday morning. That was your odds are much greater that you're not getting a surgeon who's been up working for >24hrs (which, as noted above, has roughly the same effect on motor skills as alcohol).
  • There have been pretty reasonable limits for work hours in the US since 2003; the current state of things is pretty well summed up here. This is a far cry from my internship in the late 80's, when there were no restrictions. A bigger concern to me (and one that I never see addressed) is that these hours do not apply to physicians once they are out of training. Also, I see no point in trying to schedule surgery for a Monday AM. At our hospital, Mondays can be pretty chaotic; equipment gets used during the weekend and not replaced, people may have been called in for emergencies, and so on. The best thing is to let your surgeon know you will be understanding if your surgery is postponed because he is tired, sick, or otherwise not at his best (and all of this applies even more so to anesthesiologists).
  • Yep, my sister did her internship in the late '80s. She regaled me with countless stories of 36 hour shifts, falling asleep (literally) on patients, etc. (Did I say "regaled"? I meant "appalled".) It blew my mind then, and I still dunno why we haven't heard of more (legitimate, IMO) lawsuits because of this irresponsible scheduling. Oh well, back to the Kitty Squeegee...