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Proposal for longer shifts for doctors sparks debate

Multiple studies have shown that young doctors working long hours with no breaks put their patients as well as themselves at risk. For that reason, work hour restrictions were put in place in 2011. These limited first-years residents' shifts to no more than 16 hours.

Studies have shown that residents make more potentially fatal errors the longer they're working without a break. They also endanger themselves and others when they drive home after a long shift. In one study, almost 20 percent of residents reported that they had fallen asleep behind the wheel after a long stint at work.

Now the Accreditation Council for Graduate Medical Education, a private organization that oversees physician training, is proposing that this be increased to 28 hours. In some cases this could be extended if it's determined that it's necessary for a patient's care.

Those in favor of relaxing the restrictions argue that forcing a resident to "clock out" at a particular time, regardless of the circumstances, may jeopardize patients. Further, they claim that it's good training to learn to endure long hours, because as they advance in their careers, their hours won't be restricted.

The head of the ACGME compares the road to becoming a doctor to "training for a marathon." He says. "With enough experience comes resilience and the ability to perform under expected, sometimes challenging conditions." The group is expected to vote on the proposal in February.

There is understandably opposition to the proposal by doctors as well as patients' rights advocates. One professor, who works at Harvard's Brigham & Women's Hospital, called it "deeply troubling." He has conducted studies of the effect on 24-hour-plus shifts on first-year residents' performance. He found that they made 36 percent more serious mistakes than residents working shorter shifts. Some residents were even observed sleeping on their feet.

Besides leading to physical ailments in doctors, lack of sleep can contribute to depression and other mental disorders that compromise their own well-being as well as their ability to make good decisions for their patients. Whenever a person is harmed or worse by the actions or negligence of a doctor or other health care provider, a relevant question to ask in the investigation is whether work-related fatigue was a factor.

Source: Los Angeles Times, "Young doctors could work 28 hours straight under new plan, despite possible dangers," Melody Peterson, Dec. 16, 2016

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