Yesterday we told you how the unbelievable arrogance of some doctors often leads to malpractice.
Today, the news is filled with oddly-related stories about how depriving medical residents of sleep can lead to the same result.
Although today’s reports are based on a newly released study by the Institute of Medicine (IOM), which recommends things like shorter shifts and mandatory sleep breaks for residents, the discovery that sleep-deprived medical residents tend to make more mistakes is hardly a slap-to-the forehead V-8-type of epiphany. The connection between marathon shifts and threats to patient safety has been on the medical community’s radar at least since the highly publicized Libby Zion tragedy in 1984.
Nevertheless, resistance from arrogant “old school” doctors persists. Dr. Mark I. Langdorf, medical director of the emergency department at UC Irvine Medical Center and associate director of the residency program, said the IOM’s recommendations were “nuts.”
"The problem here is balancing the need for patient safety, which I acknowledge, with the need to have the training in medicine be an apprenticeship," he said. "It sells the educational process short to make training so intermittent that you don't really get continuity."
Notably, a 2002 survey by the National Sleep Foundation found that 70 percent of respondents were likely to request another doctor if they learned that the one caring for them had been working for 24 hours. (Wonder if Dr. Langdorf would count himself among that 70 percent!)
Regardless, the most pathetic aspect of the IOM’s report is that it is unlikely to make much of a difference. According to Peter Lurie M.D., MPH, Deputy Director of the Health and Research Group at Public Citizen, that is largely because enforcement of the report’s recommendations is being left in the hands of the Accreditation Council for Graduate Medical Education (ACGME), the professional association of residency programs that has been historically lax in enforcing resident work reduction policies.
Unfortunately, said Lurie, the report “gives the appearance of taking the problem seriously, but, in fact, will likely maintain the status quo.”
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