• Skip to main content
Search
  • Home
  • Services
      • Behavioral Health
      • Bloodless Medicine
      • Brain & Spine
      • Cancer Care
      • Ear, Nose and Throat
      • Emergency Care
      • Senior Health
      • Heart & Vascular Care
      • Home Health Care
      • Immediate Care
      • Medical Imaging
      • Minimally Invasive Surgery
      • Orthopedics
      • Pregnancy & Childbirth
      • Primary Care
      • Rehabilitation Services
      • Weight Loss Surgery
      • Wound Healing & Care
      • Women's Health
  • Doctors
      • Find a Primary Care Doctor
      • Find a Doctor
      • Physician Referral
      • Practices:

        Baptist Primary Care
      • Baptist AgeWell
      • Baptist Behavioral Health
      • Baptist Endocrinology
      • Baptist ENT Specialists
      • Baptist Heart Specialists
      • Baptist Infectious Diseases
      • Baptist MD Anderson Cancer Physicians
      • Baptist Neurology
      • Baptist Pediatrics
      • Baptist Pulmonary Specialists (Nassau)
      • Baptist Rheumatology
      • Baptist Urology Group (Nassau)
      • Jacksonville Orthopaedic Institute
      • Lyerly Neurosurgery
  • Locations
    • Our Hospitals:

      • Baptist Medical Center Jacksonville
      • Baptist Medical Center South
      • Baptist Medical Center Beaches
      • Baptist Medical Center Nassau
      • Baptist Heart Hospital
      • Wolfson Children's Hospital

      Emergency Rooms (ER):

      • All ER Locations

      Imaging:

      • By Location

      • Imaging Center Locations
      • By Service

      • MRI
      • Bone Density
      • Screening Mammography
      • Diagnostic Mammography
      • Ultrasound
      • Vascular Ultrasound
      • CT Scan
      • PET Scan
      • Nuclear Medicine
      • X-Ray

      Urgent Care Locations:

      • Baptist Health Clinics at Walgreens
      • CareSpot Urgent Care

      Outpatient Locations:

      • AgeWell Center for Senior Health
      • Baptist Clay Medical Campus
      • Baptist MD Anderson Cancer Center
      • Baptist Neurodiagnostic Center
      • Baptist North Medical Campus
      • Heart and Vascular Testing Centers
      • Hill Breast Center
      • Infusion Center
      • Pharmacy
      • Rehabilitation Centers
      • Robotic Spine Surgery
      • Sleep Centers
      • Stroke and Cerebrovascular Center
      • Surgery Centers
      • Wound Care

      Health & Wellness:

      • 4her Wellness Resources for Women
      • JCA Wellness Connexion
      • Y Healthy Living Centers
  • Patient Info
      • Billing & Insurance Information
      • Insurance Plans Accepted
      • Cost Estimate Request
      • Financial Assistance Program
      • My Baptist Connect (Patient Portal)
      • Medical Records
      • Classes and Events
      • Clinical Trials
      • Tell Us What You Think
  • Health Library
      • Diseases and Conditions
      • Symptoms
      • Tests
      • Surgeries and Procedures
      • Injuries
      • Nutrition
      • Poison
      • Drug Information
      • Drug Images
      • Health News
      • Video Library
  • About Us
      • Administration
      • Awards & Honors
      • Careers
      • Provider Opportunities
      • Baptist MD Anderson Provider Opportunities
      • Spiritual Care
      • Social Responsibility
      • Community Health Needs Assessment (CHNA)
      • Corporate Wellness (PATH)
      • Volunteering
      • Newsroom
  • Juice
      • Health News Overview:

      • Aging Well
      • Brain, Spine & Nerve
      • Cancer
      • Child Health
      • Community Health
      • Diabetes
      • Ear, Nose & Throat
      • Heart & Vascular
      • Lungs, Breathing & Sleep
      • Mental Health
      • Orthopedics, Bones & Muscles
      • Pregnancy & Childbirth
      • Primary Care
      • Wellness
      • Women's Health
      • Men's Health
  1. Home
  2. Health Library
  3. Health News
  4. Do Long Doctor Shifts Hurt Patients? Study Says No

Do Long Doctor Shifts Hurt Patients? Study Says No

WEDNESDAY, March 6, 2019 (HealthDay News) -- Despite years of worry over young doctors' grueling work hours, a new study finds that longer shifts do not jeopardize patients' safety.

The trial is one of two recent efforts to test an assumption about doctors' work hours -- that shorter hospital shifts should mean better-rested physicians and fewer medical errors.

In 2011, new restrictions were put in place to limit residents' shifts to 16 hours or less. (Residents are doctors-in-training.)

Since then, however, there have been signs that the hoped-for benefits were not being realized. A 2016 trial of surgical residents found that patients fared no better under the 16-hour rule, versus those treated by doctors who were allowed to work longer shifts.

The new trial found the same was true for residents in internal medicine. The results are in the March 7 issue of the New England Journal of Medicine.

"Patients cared for by residents on longer shifts did just as well," said Dr. David Asch, the senior researcher.

The findings may seem counterintuitive. It's "natural," Asch noted, to expect residents on shorter shifts to be more alert and do a better job.

"But there are other competing issues," said Asch, a professor of medicine at the University of Pennsylvania. "It's not just, 'Is your doctor tired?'"

For example, he said, when residents' shifts are shorter, there's more "passing off of care." And a tired doctor who's familiar with you might be preferable to a fresher doctor who has never met you, Asch said.

Beyond that, the trial found that residents on shorter shifts did not actually get more sleep, on average.

Because of the 2016 trial, things have already changed: In 2017, the Accreditation Council for Graduate Medical Education relaxed the 16-hour shift rule.

These latest findings offer "more reassurance" that the change will not put patients at risk, said Dr. Daniela Lamas.

Lamas, a critical care specialist at Brigham and Women's Hospital in Boston, wrote an editorial published with the study.

She said that patients' well-being does not hinge on how many hours a resident has worked that day. "There's a lot of redundancy at a hospital, and a lot of people are actually 'in charge,'" Lamas said.

Asch made the same point. The 16-hour rule may be gone, but there are other checks in place. For example, residents cannot average more than 80 hours on duty each week, and there are rules on supervision by senior doctors.

The concern about residents' hours goes back to 1984, when an 18-year-old hospital patient named Libby Zion died under the care of a resident and intern who were nearing the end of very long shifts.

Since then, though, various safety rules have been put in place, Asch said. His team looked only at the effects of relaxing the 16-hour limit.

For the study, the researchers randomly assigned 63 U.S. residency programs to either stick with the 16-hour rule or have a more flexible setup. In that latter group, program directors could design residents' shifts at their discretion; they could keep shorter shifts for some rotations, and change to extended shifts for others.

After one year, the study found, there were no signs that flexible programs compromised patient safety.

The average 30-day death rate among Medicare patients dipped slightly in both study groups -- to just above 12 percent. And there was no difference in hospital readmissions, or in complications like infections and blood clots.

In a separate analysis, Asch's team looked at residents' sleep patterns by having a subgroup wear activity monitors for two weeks. The doctors also took a test of alertness and rated their sleepiness each workday.

Overall, residents in both study groups averaged about seven hours of sleep a day -- though those in the flexible programs were less alert after their shifts. That did not translate into differences in patient safety, however.

What's missing from trials like this, Lamas said, is how patients and families feel about their care in a setting where "your doctor" inevitably shifts.

Often, she noted, family members become critical in ensuring the "continuity of care," by asking questions and communicating with the hospital staff.

More information

The nonprofit Leapfrog Group has advice on staying safe in the hospital.

SOURCES: David Asch, M.D., professor, medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia; Daniela Lamas, M.D., pulmonology and critical care medicine, Brigham and Women's Hospital, Boston; March 7, 2019, New England Journal of Medicine

Daily Health and Medical News

  • Babies May 'See' Light While in the Womb
    December 03, 2019

  • Uncontrolled Asthma a Danger to Pregnant Women, Babies
    December 03, 2019

  • Are E-Scooters a Quick Ticket to the ER?
    December 03, 2019

  • Taking Several Prescription Drugs May Trigger Serious Side Effects
    December 03, 2019

  • AHA News: Vegan Diet May Decrease Heart Disease, Stroke Risk in African Americans
    December 03, 2019

© Copyright 2019 | All Rights Reserved

If you speak another language, assistance services
free of charge, are available to you.

Baptist Health Facebook Baptist Health Twitter Baptist Health on LinkedIn Baptist Health on Instagram Baptist Health on Youtube
Physician Login | Application Login | Employee Login
Quality Measures | Privacy | Non-Discrimination | Comments | Site Map