Shorter Shifts for Doctors Doesn't Equate to Improved Patient Care

Doctors-in-training don't perform any better when their shifts are shortened to 16 hours when compared to the current 30-hour week limitations.

This news comes in the form of not just one but two studies published on March 25 on the website JAMA Internal Medicine.

The first study looked at interns' performance when shifts were limited to 16 hours compared to the 30-hour work week limit dating back to 2003.

The former, that of restricting shift length, is in line with a change mandated by the Accreditation Council for Graduate Medical Education (ACGME) in 2011.

The difference between the two groups was so large, in fact, that the controlled trial in one had to be stopped early, according to Sanjav V. Desai of John Hopkins. In all, handoffs - which signal an increase for medical errors - rose by 130 percent to 200 percent.

The second study consisted of a survey of interns taken throughout their residency and when compared to the responses of those who underwent their first year of postgraduate training under the old work requirements, the new group's level of fatigue, depression or concern about one's well being did not improve, according to Srijan Sen of the University of Michigan, An Arbor. The only place they did increase in was their fear of making mistakes.

These studies agree with others that have been done examining the effect of the ACGME regulations and mortality rate of patients in an array of fields of medicine including pediatric, neurology, coronary, ICU, Medicare and Veterans Affairs care.

The authors of the studies suggested work schedules that "account for circadian phase" as a possible way of improving performance not just among interns, but fully-fledged doctors as well. 

However, it should be taken into account that the study conducted by Desai was small, with just 43 participants - all of whom came from an internal medicine training program at one institute. Furthermore, Sen's study was limited by self-reporting as well as the fact that only 58 percent of those invited to participate did so.