We see doctors on ER and Grey's Anatomy pulling two- and three-day shifts at the hospital, coming back on their days off, and essentially working round the clock to keep their patients safe. But over the last forty years, organizations such as the Accreditation Council for Graduate Medical Education and several state commission boards have been pushing to limit the number of hours that new doctors spend training in hospitals. In 1987, New York established an 80-hour work week for medical residents, instead of the standard 100-hour shifts with 36-hour call times. Then in 2003, doctors' hours were cut again; residents could only work in the hospital in shifts of 24 consecutive hours. Seven years later, in 2011, medical associations rolled out an even shorter shift for first-year residents—16 consecutive hours of on-site training.
Based on years of research, medical professionals saw the shorter shifts as a way to reduce the number of mistakes doctors made on the job. Medical malpractice attorneys in Florida say that long shifts caused high levels of stress and extreme sleep deprivation, which can lead to errors in judgment, diagnosis, or treatment. In the 1984 case of Libby Zion, an 18-year-old New York girl, an on-call doctor's oversight proved to be fatal. Zion was admitted to a city hospital with a fever and convulsions. Doctors treated her initially with opiates, and restrained her, but never came back to check on her progress. Zion's fever spiked, and she went into cardiac arrest and died. This case was pivotal in exposing the dangerous effects of such long hours on doctors in training.
However, in the two years since the most recent cutbacks, Florida medical malpractice lawyers report that shorter shifts may not be accomplishing what the medical association set out to do. First-year residents and medical professionals are finding that cutting back on their hours means cutting back on their learning. Interns in the hospital are still expected to keep up with previous years' classes, and with the new regulations, they have less time to benefit from hands-on experience. New doctors also have fewer hours in their shifts to reevaluate the medical decisions they are making, and catch any mistakes they might have missed at first.
The time crunch also leads to a lot of handoffs—as many as nine in one shift—between doctors as they rapidly change shifts. Patients' charts are passed around, and doctors are often working from a colleague's charts and decisions. Florida medical malpractice lawyers say that these handoffs are the cause of many malpractice lawsuits, because of risk of miscommunication between doctors, about allergies, medical history, and diagnoses is higher.
Since 2011, research has shown a 15-20% increase in errors in the last few years, as doctors and hospitals alike adjust to the new regulations. While these errors may be part of the transitional period, it is also likely that the rationale behind shorter shifts failed to take into account the full range of the training period for medical residents. The medical malpractice attorneys at Florida law firm Lubell Rosen say that, going forward, doctors and patients alike will have to see whether or not the shorter shifts are beneficial in the long run.