Appearances aren’t lying if the doctor you visit in hospital looks drunk, but don’t blame alcohol. According to research reported in September in Canada’s Globe and Mail and other newspapers, many resident doctors are so sleep-starved they are drunk with fatigue. The new study shows just how impaired they are, and could shake up hospital administrators. Fatigued doctors are unproductive, inefficient and a danger to patients and themselves. Allowing them to work in an impaired state is not ergonomically sound.
The author is Dr. Judith Owens, director of the pediatric sleep-disorders clinic at Hasbro Children’s Hospital in Providence, Rhode Island. She said some of the subjects in her study were so fatigued they didn’t even recognize their judgment was impaired.
For the study, which was published in the September 7 edition of the Journal of the American Medical Association, Dr. Owens followed 34 pediatric residents from Brown University in Providence for over two years. They were tested during two distinct work patterns. On light call – one month of daytime duty with no overnight shift – they averaged 44 hours of work per week and six hours and 37 minutes of sleep a night. On heavy call – overnight duty every fourth night – they averaged 90 hours of work a week and averaged only three hours and 26 minutes of sleep a night.
The heavy schedule figure exceeds the recommended weekly work schedules for doctors-in-training in the United States, which was lowered in 2003 to a maximum of 80 hours. The limit is not legislated.
The doctors were tested four times in total after their shifts. Two tests following light call shifts, and for one of these tests they drank four vodka cocktails. Two tests followed heavy call shifts, and for one of these they consumed enough alcohol to put them at the legal limit for driving in many parts of the United States. The tests