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A paradox for young docs: New work-hour restrictions may increase, not decrease, errors
Date:3/25/2013

ANN ARBOR, Mich. At hospitals around the country, young doctors fresh out of medical school help care for patients of all kinds and work intense, long hours as part of their residency training.

Traditionally, residents were allowed to work more than 24 hours without a break. In 2011, new rules cut back the number of hours they can work consecutively to 16, in the name of protecting patients from errors by sleepy physicians.

But a new study of more than 2,300 doctors in their first year of residency at over a dozen hospital systems across the country raises questions about how well the rules are protecting both patients and new doctors.

While work hours went down after new rules took effect in 2011, sleep hours didn't go up significantly and risk of depression symptoms in the doctors stayed the same, according to a new paper published online in JAMA Internal Medicine by a team led by University of Michigan Medical School researchers.

Most concerning: the percentage of residents reporting that they had committed medical errors that harmed patients went up after the new rules took effect.

The results, especially the increase in errors, surprised Srijan Sen, M.D., Ph.D., the U-M psychiatrist who is the report's first author.

"In the year before the new duty hour rules took effect, 19.9 percent of the interns reported committing an error that harmed a patient, but this percentage went up to 23.3 percent after the new rules went into effect," he says. "That's a 15 to 20 percent increase in errors -- a pretty dramatic uptick, especially when you consider that part of the reason these work-hour rules were put into place was to reduce errors."

The findings echo anecdotal reports about the impact of the 2011 duty hour rules.

Co-author Sudha Amarnath, M.D., a resident in the radiation oncology program at the University of Washington, says, "Many interns entering after the new work hour r
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Contact: Kara Gavin
kegavin@umich.edu
734-764-2220
University of Michigan Health System
Source:Eurekalert

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