No more sleepy doctors?

Photo: Sleepless and Tired

Yesterday's New York Times Magazine had an article on the new ACGME residency work hour rules written by a pediatric cardiologist. I think it presents a balanced view of the the topic and it interests me for several reasons. I recall several scary episodes from my own sleep-deprived residency days, including giving nurses verbal orders in my sleep, but I was luckier than one of my colleagues who demolished his car after a night on call. As a hospital epidemiologist, my interest in the new rules revolves around whether there will be any impact on medical errors, which the article points out is still open for debate. As a medical educator, I'm also interested in the impact on medical education, which the article does not address. Will the decreased hours and the associated decrease in clinical experience lead to less competent doctors? And the rules have also impacted the work environment in the hospital, a topic I addressed in an essay published last year. While I favor the rules and strongly support having well-rested doctors, I do worry about the adverse unintended consequences.