"I have eliminated all 24-hour shifts for anesthesiologists," Lubarsky said. "It did increase staffing costs, but I do believe it decreased our error rates."
Lubarsky noted, though, that working long hours is part of the medical culture.
"It takes years of training to get to where you are going to be able to practice," he said. "And people who are unable to function on little sleep -- and there are many -- they just don't make it through the program. You've got to have that level of dedication and intestinal fortitude."
However, Lubarsky said, good doctors are better doctors when they have had enough sleep.
Nonetheless, many doctors believe they can function just as well on little rest.
Doctors are trained to "think they are critical to the care of the patient, and they don't like handing that off," Lubarsky said. "To get where we need to be, we have to get more of a team-based approach to the provision of care. We're just not there yet."
The U.S. Agency for Healthcare Research and Quality has more on improving patient safety.
SOURCES: Jeffrey M. Rothschild, M.D., M.P.H., associate physician, Brigham and Women's Hospital, and instructor, medicine, Harvard Medical School, Boston; David A. Lubarsky, M.D., Emanuel M. Papper professor, chairman, Department of Anesthesiology, Perioperative Medicine and Pain Management, and senior associate dean for quality safety and risk prevention, University of Miami Miller School of Medicine, Miami; Oct. 14, 2009, Journal of the American Medical Association
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