The Institute of Medicine has recommended more caps for the amount of time that doctors, particularly resident doctors, can spend on duty consecutively. While caps are not a new idea, this time the panel suggested that anyone working the maximum 30 hour work shift be given a five hour rest following the first 16 hours.
"Our committee's charge was not to focus necessarily on longer scheduling or shorter scheduling, but smarter scheduling to try to really identify the areas where we could have an impact in preventing excessive fatigue, both acute and chronic, that might contribute to medical errors," said Dr. Daniel Munoz of Johns Hopkins University School of Medicine in Baltimore.
Medical mistakes often occur due to explainable events. Sleep deprivation "fogs the brain," which is one reason caps in 2003 limited resident work weeks to 80 hours per week.
While cutting hours can help, what truly is needed is a comprehensive reform of hospital work-load that puts the safety of the patient before either simple finance or even the education of a resident.
"Cutting hours alone won't do it," added Dr. Ann Rogers of the University of Pennsylvania School of Nursing in Philadelphia, who also served on the committee. "We need to pay attention to work load. We need to pay attention to supervision. The whole package will make a difference. Without it, you could end up with a more severely stressed resident trying to do more work with less hours."
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