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Sleepy Doctors

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Working extremely long hours is not just a rite of passage for young doctors, it's now routine. In some cases, medical and surgical residents in a hospital may work as many as 120 hours a week.

Now a new study says those long hours may be putting patient safety at risk.

Pulling the occasional all nighter is fine for college students, but when you are a physician and patients' lives are in your hands, it's a very different matter.

Dr. David Gaba of VA Palo Alto Hospital says, "The kinds of work hours and duty periods over 30 to 36 hours will lead people to fall asleep while they are working and possibly to make errors, because their judgement is impaired even while they are awake."

Dr. Gaba and Dr. Steven Howards used medical simulators and other techniques to study the effects of working long periods without rest.

They say depriving someone of sleep has a clear impact on their ability to function at their best.

Dr. Howard says, "Certainly psychomotor function changes, memory changes, and people falling asleep can't actually perform."

Their study, in the New England Journal of Medicine, says medicine needs to follow the example of other professions that place limits on how long people can work without a break.

"Pilots have their hours regulated, truck drivers have their hours regulated, and they are significantly less than what a physician will work," Dr. Howard explains.

The researchers say we need to make big changes, including working shorter shifts, and limiting high intensity work such as surgery to daytime shifts. They say we can no longer pretend it is not a problem.

"I think it's quite clear from the sum total of what we know that it is a problem, we do have to deal with it, for the benefit of our patients and for the benefit of ourselves," Dr. Gaba says.

Dr. Howard adds, "I wouldn't want my phsycian falling asleep when caring for me."

In England and Europe physicians in training are limited to working less than 60 hours a week, far fewer than their counterparts here in the U.S. Changing the system here won't be cheap, but not changing it comes with possibly even greater costs.

Residency programs nationwide are currently addressing this issue, trying to strike a balance between work hours and education.

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