In 2003, the Accreditation Council for Graduate Medical Education reduced the number of continuous hours that doctors-in-training could work without a break. In 2011, the organization lowered the number of hours again.
An article published on the JAMA Internal Medicine website on March 25th, however, shows that the new rules might not actually improve conditions for patients. In fact, the new shift limits seem to make conditions worse for patients by increasing the number of medical mistakes made by doctors.
Medical students used to work up to 30 hours at a time. Today, first-year students work in 16-hour shifts, still a considerable amount of time that would send most people in search of new work.
The shift changes seemed to make a lot of sense. Wouldn’t a young medical student working a 16-hour shift be able to focus better than one who has been working for 30 hours? If medical providers want to give patients the best possible services, shouldn’t they make it possible for doctors to get some sleep, at least every now and then?
The latest research shows that the shorter shifts might not actually benefit patients. In fact, the 16-hour shifts could create more problems than they will potentially solve.
Shorter Shifts Could Decrease Quality of Care
One problem is that shorter shifts mean medical students have to trade off patients more often. Instead of monitoring a patient for 30 hours, the student monitors her for 16 and then hands the responsibility over to another student. That second medical student might not have all of the information needed to make the best care decisions for the patient.
Ideally, all information would get passed along, but some aspects of medical care involve watching a patient and making note of progress. It’s difficult to note barely perceptible changes when more than one person cares for a patient.
Shorter Shifts Mean More Work in Less Time
Some researchers have also found that many hospitals cannot afford to hire more doctors to cover shorter shifts. That means young doctors who would have spent 24 hours performing a certain amount of work in 2011 now have to do the same amount of work in 16 hours.
That makes it nearly impossible for doctors to do their jobs as thoroughly as they once did.
Medical errors increased from 20 to 23 percent during the first few months of shorter shifts.
Shorter Shifts Aren’t Helping Students Either
To make this situation even worse, medical trainees say that they’re not getting more sleep now than they did before the shifts were shortened.
If the students aren’t getting more rest; they’re making more mistakes; and they feel more stressed to perform work in shorter shifts, who benefits from this change?
Shorter shifts seem to make a lot of sense, but the changes were made without significant study. Now hospitals are finding out that the common sense approach could have negative consequences for everyone.