14 January 2005


Last October I posted something on how dangerous it is to have sleep-deprived doctors take care of you when you're sick in the hospital. This time, here's another post to reinforce what we have long known but never bothered to address.

Sleep-Deprived Young Docs Prone to Auto Accidents

NEW YORK (Reuters Health) - Trainee doctors have double the risk of having a car crash when they work more than 24 consecutive hours, according to a new report.

"Scheduling physicians to work such extended shifts....poses a serious and preventable safety hazard for them and other motorists," Dr. Charles A. Czeisler, from Harvard Medical School in Boston, and colleagues note in this week's New England Journal of Medicine.

At present, however, the Accreditation Council for Graduate Medical Education guidelines still allow interns to work up to 30 consecutive hours every other shift, the investigators point out.

The new findings are based on a survey of 2737 interns who completed monthly reports detailing their work hours, motor vehicle crashes, and near-miss incidents. An extended work shift was defined as at least 24 consecutive hours.

Working an extended shift raised the risk of crashes and near-miss incidents by 2.3- and 5.9-fold, respectively.

[Reuters Health ]

Actually, this a no-brainer, and you don't need a study to confirm that a sleepless person is not as keen and sharp as compared to a condition when he had ample rest and sleep. But someone had to document it for everyone to see and appreciate the gravity of the situation.

Dr. Charles A. Czeisler, of Harvard Medical School in Boston, and one of those who conducted the study, emphasized that this is "a serious and preventable safety hazard."

Serious and preventable? Is anyone doing anything about it?

When I was a post-graduate intern at PGH, I remember going without sleep for more than 48 hours. When I get home, I sometimes sleep without even changing my clothes. I was THAT exhausted. It was already a luxury if I can sleep for 6 hours straight without getting a beep in my pager.

Physical exhaustion is just one of the many "tests" an intern has to hurdle before he or she becomes a true doctor. There's also mental exhaustion, from all those laboratory values, drug dosages, and remembering what clinical management and diagnostic procedure went to what patient. Another exhaustion is emotional, which is what happens when you lose a patient for the first time (or many times, depending on the case) and when you commit a mistake and you get a dressing down from your senior doctors.

This has been the doctor-training tradition that has been going on for years, not only here in the Philippines, but all over the world.

Up to now, having survived all of those, I still do not get the logic behind it. Why the punishing schedule when it can be avoided?

Doctors are trained to save and preserve lives. Being human, however, they get tired too, commit unnecessary mistakes, and unwittingly become "walking death threats," not only inside the hospital but on the road, too.

So while concerned medical authorities persist on maintaing the current training policy of young doctors, I advise you all to be careful, and avoid drowsy doctors on the road.

[The full text of the study can be read from the current issue of this week's New England Journal of Medicine]

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