Not that long ago, it was common for first year residents to spend 100 or more hours a week in the hospital working or on call. Those demanding schedules were blamed for a number of medical errors that led to tragic results. In response, the Accreditation Council for Graduate Medical Education passed rules for all accredited medical programs that limited to trainees to work shifts that could not exceed 24 hours consecutively. Work hour restrictions among new doctors have undergone several revisions, most recently in 2011. The latest changes restricted new doctors from working a shift longer than 16 hours. The latest hours changes may have had unintended consequences, however. While reports of insufficient sleep and depression have remained steady, first year interns are reporting a significant increase in mistakes that cause patients harm.
When compared with interns who worked before the new rules were implemented, the latest first year interns reported more medical errors resulting in patient harm. In total, 23.3 percent of recent interns reported having made medical errors. Prior to the changes, 19.9 percent of first year interns reported medical errors. The purpose of the rule change was to encourage interns to be better rested during working hours. Instead, it may have increased the pressure to treat patients in a short time frame.
Recent studies have analyzed the amount of time doctors and patients spend together before treatment is ordered. Consultation times have dropped all over the nation. First-year interns are spending less time in the hospital, but they are being asked to treat the same number of patients as before the changes went into effect. The result is a work force that feels rushed and is making mistakes at a higher rate.
Source: Time, “Fewer Hours for Doctors-in-Training Leading To More Mistakes,” by Alexandra Sifferlin, 26 March 2013
