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Even With More Sleep, Medical Residents Commit More Medical Errors

2 comments

Too little sleep and I don't do too well, but can you imagine the consequences for those who are responsible for other peoples' lives? Past studies found a link between doctors in training who get too little sleep and an increased number of medical mistakes. But a new study delved in a little deeper into the connection and found that even with more sleep and shorter work hours, medical residents still made the same number, if not more, mistakes. So what gives?

Since 2011, regulations were put in place that limited the amount of time that first-year residents could spend continuously on the job from 24 to 16 hours because of the connection between lack of sleep and medical mistakes. However, the latest data published in JAMA Internal Medicine found that interns working under the new conditions were still reporting medical mistakes, not enough sleep, and signs of depression. It turned out that even though the interns were spending less time at the hospital, the percentage of medical errors rose from 19.9% to 23.3% and the risk of depression stayed the same at 20%.

The problem is that the relationship between lack of sleep and medical mistakes is more complicated than what was originally thought. First, although interns are spending less continuous time at the hospital, they are still expected to accomplish the same amount of work without any additional help. Additionally, hand-offs between residents have increased, and any time a physician passes on a patient to another doctor, there is a chance of miscommunication and medical error. Some studies have shown that patient pass-overs have increased from an average of three during a single shift to upwards of nine. Naturally, the more often a patient is passed-over to another doctor, the greater the risk for medical error. The authors of the current study published in JAMA Internal Medicine recognize that their results are preliminary, but argue that finding the right balance between humane working conditions for interns and quality patient care is key for everyone involved.

2 Comments

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  1. Tanichthys says:
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    This is shocking. To little sleep can drestically reduce my concentration and I can’t even think about people who are responsible for other people’s lives.

  2. Peter Egan says:
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    My sister recently completed her residency at a university-run hospital in Louisiana. She told us horror stories about working 38-40 hours out of a 48 hour period. That doesn’t leave a tremendous amount of time to eat, sleep and bathe.

    I’ve been known to work long hours, as my own girlfriend will readily attest. Then again, my work has no impact on anyone’s health in the same way that a doctor does. To me, it’s absolute insanity that this entrenched system of what I liken to an initiation or hazing has become so universally accepted within the American healthcare system.