No Doc­tor Should Work More than 30 Hours

The HR Digest - - Content Features -

The sub­ject of work­ing be­yond the max­i­mum 28 hours per shift has al­ways been a sub­ject of heated de­bate within the med­i­cal com­mu­nity. The AAA Foun­da­tion for Traf­fic Safety re­leased the find­ings of a study re­leased this month, which noted that driv­ers who sleep only five or six hours in a 24-hour pe­riod are twice as likely to crash as those who got seven or more.

The find­ing led AAA’S direc­tor of Traf­fic Safety Ad­vo­cacy and Re­search Jake Nel­son to rec­om­mend on NPR:“IF you have not slept seven or more hours in a given 24-hour pe­riod, you re­ally shouldn’t be be­hind the wheel of a car.”

On the other hand, the Ac­cred­i­ta­tion Coun­cil for Grad­u­ate Med­i­cal Ed­u­ca­tion (ACGME) on Nov. 4 pro­posed a new set of guide­lines for the num­ber of hours worked by res­i­dent physi­cians. This lifts the 16 con­sec­u­tive-hour limit on first-year res­i­dent work shifts and al­lows them to work up to 28 con­sec­u­tive hours, without sleep.

“I did a week­end of 72 hours in which I only got four hours of sleep. I would also se­cretly hope to get in a car ac­ci­dent and maybe break a leg so that I would be force to take off from work...just so I could get some rest. Thank God, I never got in an ac­ci­dent, but I have had col­leagues fall asleep at the wheel.”

--Writ­ten public tes­ti­mony from Dr. Betsy Greenleaf on pro­posed work hour changes A 2014 study by North­west­ern re­searchers com­pared pro­grams which per­mit­ted res­i­dents to work longer shifts. The res­i­dents weren’t given eight hours off be­tween shifts, or 14 hours off af­ter a 24-hour shift. In these hos­pi­tals, the rates of death and sur­gi­cal com­pli­ca­tion were com­pa­ra­ble. The au­thors of the study con­cluded that “flex­i­ble duty-hour poli­cies for sur­gi­cal res­i­dents were non-in­fe­rior to cur­rent ACGME duty-hour poli­cies with re­spect to pa­tient out­comes.”

The so­lu­tion is clear: no pro­fes­sional, in­clud­ing doc­tors, should work be­yond the point where neu­ro­bi­ol­ogy fails our sys­tem to func­tion ad­e­quately.

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