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Study: More Sleep for Doctors Doesn't Increase Patient Deaths

Posted September 4, 2007

Cutting the hours that resident doctors work has not increased patient deaths, and two recent studies suggest the reason why might be fairly simple: Residents are getting more sleep.

In 2003, new regulations cut the number of hours that resident doctors could work each week from 120 to 80. Some feared the reduced work hours might increase patient deaths, since more residents would treat a single patient, leading to the possibility of  miscommunication among residents.

Residents are newly licensed physicians who are receiving in-depth training in a specific branch of medicine.

Two recent studies published in the Journal of the American Medical Association examined death rates after the reduced work hours began. Researchers reviewed data on more than 8 million Medicare patients and more than 300,000 Veteran Affairs patients.

"What we found was that there was no catastrophe. There was not an increased number of deaths," said study co-author Dr. Jeffrey Silber, with the Children's Hospital of Philadelphia.

Researchers found that more well-rested residents performed better.

"As a patient, you should be glad that the residents who are caring for you are probably better rested, because on average, they're working fewer hours than they used to work before work hours were regulated," said study lead author Dr. Kevin Volpp, with the Philadelphia Veteran Affairs Medical Center.

VA patients actually experienced a decrease in their death rate, according to the studies. Volpp attributed that drop to a new electronic health-records system, which provides better information for different doctors treating the same patient.

Volpp urged more refinement of rules regarding residents' work schedules and the care they provide.

"We need to continue working to try to develop better models of work-hour regulation that may lead to further improvements in outcomes," he said.

Residents agreed that lighter work schedules could improve patient care.

"Really, the goal should be to try to decrease the amount of fatigue and to provide safe options, so we can continue to take good care of our patients," resident Dr. Meredith Pugh said.

12 Comments

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  • Fair Tax Now Sep 5, 2007

    And we were thinking that giving doctors more rest would increase patient deaths?

  • brassy Sep 5, 2007

    Funny, doctors are always telling the public they don't get enough sleep. "Do as I say and not as I do."

  • bill0 Sep 5, 2007

    Actually, the study didn't find what is was looking for. The "common sense" answer was that doctors who got more rest would perform better - not just equally. In 3 of the 4 tests, cutting the hours worked did not improve patient survival rates. The improvement from more alert doctors was offset entirely by the complications of having more doctors involved with each patient. If you have ever been in a hospital and had seemingly hundreds of people rotate through your room, that is a pretty scary thought! Mistakes are so common and communication so poor that you receive about the same care as if your doctor was actually asleep or legally drunk.

  • Frank Downtown Sep 5, 2007

    yea, I want a doctor that has worked two weeks straight at 18 hours a day. Thats make me feel so much safer and better about the care. Its no wonder hospitals are dangerous?

  • murdock Sep 5, 2007

    It had been a rite of passage to have little sleep as a resident until the new regulations came out in July 2003. Since then, the concerns have been made that residents do not learn as much with restrictions. For example, having to leave in the middle of a surgical procedure) would expose the resident to less skille and therefore, they would be less competent at the end of the residency. This study is basically saying that the regulations have not made worse physicians, but better because the performance and learning is greater with the restrictions. Yes, it seems to be common sense, but then again, who wants to wait to go to the ER in the morning? Medicine happens 24 hours a day.

  • Newsjunkie Sep 5, 2007

    This has been an ongoing issue with resident doctors for years and years. They were expected to work 120+ hours a week with no sleep! I never understood this practice, but apparently old habits are hard to break. Finally someone figured that a person that was without sleep for over 24-48 hours just might be a tad fatigued. Duh! I've heard it said that lack of sleep is equal to or more dangerous than being intoxicated when driving. Where was the medical profession's common sense all these years?

  • Gottalovemy4dogs Sep 5, 2007

    This had to be common sense. They (doctors) say that the reflexes of a person who has been awake for 24 straight hours are equal to those of someone who is legally drunk.

  • Greyhound_Girl Sep 5, 2007

    "Some feared the reduced work hours might increase patient deaths, since more residents would treat a single patient, leading to the possibility of miscommunication among residents."

    They were afraid that more different resident Dr's would be seeing each patient and therefore, there might be a lapse in care due to miscommunication. Ex. the morning resident was supposed to run tests and give medication, but forgot the medication; the lunch-time resident assumed that the morning resident gave medication and never checked to see if it was administered...the patient needed the medication and dies.

  • ajstarrrn Sep 5, 2007

    Wonder how much it cost to conduct this study? Seems like common sense to me that patient deaths would not increase with better rested doctors.

  • Adelinthe Sep 5, 2007

    "Cutting the hours that resident doctors work has not increased patient deaths..."

    Don't understand this. Weren't we looking for a decrease with better rested doctors?

    God bless.

    Rev. RB

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