Restrictions on Hours for Doctors In Training Hasn’t Reduced Medical Errors

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When restrictions on the number of hours worked by interns was enacted, it was supposed to lead to fewer medical errors. However, a new study suggests that approach hasn’t worked. In fact, medical errors have increased. According to Time, “In 2011, those hours were cut even further, but the latest data, published online in JAMA Internal Medicine, found that interns working under the new rules are reporting more mistakes, not enough sleep and symptoms of depression. In the study that involved 2,300 doctors from more than a dozen national hospitals the researchers compared a population of interns serving before the 2011 work hour limit was implemented, to interns working after the new rule, during a three-month period. The former group were on-call every fourth night, for a maximum of 30 hours, while the latter group worked no more than 16 hours during any one shift. They gathered self-reported data from on their duty hours, sleep hours, symptoms of depression, well-being and medical errors at three, six, nine and 12 months into their first year of residency. Although the trainees working under the current work rules spent fewer hours at the hospital, they were not sleeping more on average than residents did prior to the rule change, and their risk of depression remained the same, at 20%, as it was among the doctors working prior to 2011 as well. And the number of medical errors the post-2011 doctors reported was higher than that documented among previous trainees. “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,” said study author Dr. Srijan Sen, a University of Michigan psychiatrist in a statement. “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.”

Mark Abramson
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