Medical Residents May Be Dangerously Fatigued

March 2, 2013  

Everyone who has ever known a doctor or who has watched doctor shows on television knows about the medical residency process. The medical residency process is essentially an apprenticeship (and a test of endurance) wherein a medical school student or med school graduate observes and provides care under proper supervision. The purpose is to learn medical techniques and get real-world hands-on practice treating patients. Residents typically work very long hours, often for minimal pay, and may be on call with few vacations or days off for lengthy periods of time.

While long nights and days may seem a rite of passage for new doctors, on February 22, however, the Wall Street Journal addressed the potential dangers created by a system where those providing care are continuously overtired. Our Boston injury attorneys believe that the points made in the Journal are extremely important ones that should give any patient cause to be concerned.

Medical Residents May be Dangerously Fatigued
According to the Wall Street Journal, there was no limit on the number of hours that a medical resident could work prior to 2003. This meant that residents could work multiple 36-hour shifts in could end up getting little or no sleep for days.

To try to address this problem, the Accreditation Council for Graduate Medical Education established a new rule in 2003. The Accreditation Council is the Council that approves and accredits training programs in U.S. hospitals so hospitals must comply in order to remain eligible to train resident physicians. The Accreditation Council's new rule limited residents to working only 80 hours per week. In 2011, the Accreditation Council then went even further and banned first year residents from working 24-hour overnight shifts.

Some, however, suggest that hours could be cut even further. In Europe, for example, residents are limited to working only 48 hours per week. One argument in favor of imposing a tougher limit more closely resembling the European standard is that cognitive performance is reduced because of fatigue. A person who gets insufficient sleep, in other words, can be just as impaired and have functioning just as interrupted as a drunk driver and probably shouldn't be making life and death decisions.

Counter-arguments also exist, of course, and were published in the Wall Street Journal as well. The author of the article, for instance, indicates that the cost of further restricting residents hours could be crippling for cash-strapped hospitals. Further, the author suggests that this extra cost might not be worth it since there is no evidence that limits on residents hours actually help people to stay safe. In fact, shorter shifts means more frequent hand-offs of patients from on doctor to another, which creates a continuity problem that can be dangerous.

How to Keep Patients Safe
The top priority in every situation should be keeping patients safe. Unfortunately, it is unclear whether it is best to restrict residents from working too long, thus avoiding the risks of fatigue but increasing the risk of information being lost as a patient transitions from one care giver to another.

It does, however, seem clear that there is some need to limit the amount of hours that a resident works. Whether the limit should stay at 80 or be reduced to a lower number is an area of controversy, but almost all agree that there does need to be some guidelines to prevent residents from providing medical help when they are too overtired to be safe and effective.

If you or a loved one has been injured by doctor negligence in the Greater Boston area, contact the medical malpractice attorneys at the Law Offices of Jeffrey S. Glassman, LLC for a free consultation. Call 1-877-617-5333.