The subject of working beyond the maximum 28 hours per shift has always been a subject of heated debate within the medical community. The AAA Foundation for Traffic Safety released the findings of a study released this month, which noted that drivers who sleep only five or six hours in a 24-hour period are twice as likely to crash as those who got seven or more.
The finding led AAA’s director of Traffic Safety Advocacy and Research Jake Nelson to recommend on NPR:“If you have not slept seven or more hours in a given 24-hour period, you really shouldn’t be behind the wheel of a car.”
On the other hand, the Accreditation Council for Graduate Medical Education (ACGME) on Nov. 4 proposed a new set of guidelines for the number of hours worked by resident physicians. The lifts the 16 consecutive-hour limit on first-year resident work shifts and allows them to work up to 28 consecutive hours, without sleep.
“I did a weekend of 72 hours in which I only got four hours of sleep. I would also secretly hope to get in a car accident and maybe break a leg so that I would be force to take off from work…just so I could get some rest. Thank God, I never got in an accident, but I have had colleagues fall asleep at the wheel.”
–Written public testimony from Dr. Betsy Greenleaf on proposed work hour changes
A 2014 study by Northwestern researchers compared programs which permitted residents to work longer shifts. The residents weren’t given eight hours off between shifts, or 14 hours off after a 24-hour shift. In these hospitals, the rates of death and surgical complication were comparable. The authors of the study concluded that “flexible duty-hour policies for surgical residents were non-inferior to current ACGME duty-hour policies with respect to patient outcomes.”
The solution is clear: no professional, including doctors, should work beyond the point where neurobiology fails our system to function adequately.