Tired Doctors and Medical Errors

It's been shown that tired doctors are more likely to make medical errors. The question is how long physicians can work before they become dangerously fatigued.

Fatigued Doctors Make More Serious Medical Mistakes

A 2007 article in The Joint Commission Journal on Quality and Patient Safety outlined several research efforts providing evidence that sleep-deprived care givers cause more medical mistakes:

• Nurses working more than 12.5 consecutive hours are up to three times more likely to make an error than those working shorter shifts
• Hospital residents (doctors in training) who work 24-hour shifts made 36 percent more serious medical mistakes than those working 16 hours
• Residents working 24-hour shifts made five times as many errors in diagnosis than those working 16 hours
• Residents working 24-hours shifts made three times more fatal medical errors than those working 16 hours

In 2011, the Accreditation Council for Graduate Medical Education, a private, non-for-profit organization that accredits U.S. graduate medical educational programs, reduced residents' work shifts in hospitals to 16 hours. ACGME also required a break of eight hours between shifts.

These shorter doctor workloads, however, are coming under scrutiny.

A trial program at 159 U.S. hospitals ran from July 1, 2014 through June 30, 2015 and allowed general surgery residents to work longer hours than the 16-hour limit. Called the Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST), the trial's results have not yet been reported.

St. Louis Hospitals in Trials That Increase Doctors' Hours

A related trial, called the Individualized Comparative Effectiveness of Models Optimizing Patient Safety and Resident Education (iCOMPARE), began July 1, 2015. It involves 63 U.S. hospitals - including facilities in the St. Louis-based Washington University medical system - and permits internal medicine residents to work shifts of 28 consecutive hours.

The goal of both studies is to determine whether the rate of serious or fatal medical errors goes up when physicians work longer than today's 16-hour maximum.

There are groups who are protesting these trials based on the previous documentation that the longer physicians work the more likely they are to make mistakes. They say these trials are putting patients needlessly at risk.

Proponents of the trials say there are dangers to limiting physicians' hours. For example, doctors working shorter shifts mean more patient hand-offs. They argue that miscommunication during those hand-offs can lead to serious hospital medical errors.

Regardless of the trials' findings, hospitals should have measures in place to prevent overly tired physicians from harming patients.

If you had a family member die or if you suffered a serious injury because of a hospital mistake, consult an attorney who represents medical malpractice victims to determine who is responsible and hold them accountable.

The choice of a lawyer is an important decision that should not be based solely on advertising.