New doctors will soon be able to work up to 28 hours in a row on a single shift under a new regulation from the Accreditation Council for Graduate Medical Education (ACGME). The regulation applies to residents – doctors who have completed medical school but are not yet attending physicians. Under the current regulation, which went into effect in 2011, residents can only work a maximum of 16 hours in a single shift. The new regulation, set to take effect July 1st, 2017, allows regular shifts for residents of up to 24 hours, with a possible four hour extension if the resident is transitioning a patient to another doctor. However, the doctor’s hours are still limited to a maximum of 80 in one week.
While it is not uncommon for physicians to work very long hours, sleep deprivation can be detrimental to delivering quality healthcare. Lack of sleep can result in many harmful effects such as impaired brain activity, memory problems, cognitive dysfunction, moodiness, depression, weakened immune response, type 2 diabetes, high blood pressure, heart disease, and an increase in the likelihood of accidents. In addition, extreme sleep deprivation, such as that allowed by the new regulation, can lead to ‘microsleeps’, in which people fall asleep for up to thirty seconds, potentially with their eyes open.
Perhaps even more alarmingly, sleep deprivation for 25 continuous hours is equivalent to a blood alcohol level of .15 percent. Needless to say, patients are right to be concerned about the healthcare being delivered by a well-meaning but sleep deprived doctor who has been up for over a day. Patients and their families depend on doctors to make life or death decisions and crucial diagnoses, but the new regulation begs the question whether patients are best served by allowing new doctors to stay awake for such a long period of time. There are indications from studies that reducing continuous hours in a shift improves healthcare outcomes, although astoundingly, as many as two-thirds of residents regularly break the rule, according to the New York Times.
The new regulation allowing for longer shifts comes at a time of increased medical malpractice payouts. In Alabama in 2014, the total medical malpractice payout amount was over $47,000,000, according to Insurance Journal. Misdiagnosis was the most commonly cited reason for malpractice complaints. While it may seem that limiting the shift time for new doctors will help prevent misdiagnosis, and in turn, bring down healthcare costs, the ACGME has regrettably decided to lift the hours cap.
In order to receive the best possible healthcare for you and your loved ones, consider asking how long a doctor who appears sleep deprived has been awake. Just as sleep deprivation can impair anyone’s ability to do a job well, the healthcare delivered by a sleepy doctor likely will be of a lower quality than that provided by a well-rested doctor. As the ACGME regulations no longer will protect patients, it’s becoming increasingly important to protect yourself. If you or a family member has been injured in a medical accident, contact us today for a free case evaluation.