Drowsy Doctors? Young Physicians Protest Long Work Hours
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Sonya Rasminsky, MD, a second-year psychiatry resident at Cambridge Hospital in Boston, tells WebMD that overworked physicians can lose their compassion for patients, seeing them more as an impediment to sleeping rather than as individuals needing care.
The petition argues, "Multiple studies in the medical literature demonstrate that sleep-deprived and overworked residents are at increased risk of being involved in motor vehicle collisions, suffering from depressed mood and depression, and giving birth to growth-retarded and/or premature infants."
The petition also claims that research has demonstrated that sleep deprivation has hurt residents' performance on interpreting electrocardiograms, monitoring anesthesia, intubating mannequins, and even removing gall bladders.
According to Sidney Wolfe, MD, director of Public Citizen's Health Research Group, there is "no question" that patients die each year because of fatigued residents.
As an intern last year, Rasminsky says she sometimes worked up to 36 hours in a row. "The culture of medical education celebrates such acts of self-destruction by calling them self-discipline and self-reliance," she says.
But Jordan Cohen, MD, president of the Association of American Medical Colleges (AAMC), tells WebMD that federal rules are not the right way. "There is an issue about assuring that patients are safely cared for," he says, but control over resident working conditions should stay with the "residency review committees" that are run through the accrediting council for graduate programs. The council is partially controlled by AAMC.
According to Cohen, the "vast majority" of residency programs comply with the council's standards. He adds, however, that some hospitals may be forced to require more of residents. But that, he says, is to ensure that often-uninsured patients receive care as hospitals struggle with tight budgets.
Regardless of the success of today's petition, the climate is generally warming to improved rights for residents.
In November 1999, the National Labor Relations Board made a landmark ruling that gave 90,000 residents, interns, and fellows in private hospitals the right to collectively bargain over their working conditions.
And last year for the first time, the governing body for residency programs published overall work-hour violation tallies for the nation's residency programs.