Interns Work Fewer Hours, But Make More Medical Mistakes

In 1984, a teenage girl named Libby Zion died within 24 hours of being admitted to the emergency section of a New York City hospital. Her father believed it was because the resident physicians and interns who attended her were overworked, fatigued, and stressed. A subsequent investigation determined that the doctors had misdiagnosed Libby’s condition and given her medications that contributed to her eventual cardiac arrest and death.

Libby’s father filed a doctor malpractice case. In 1989, New York state adopted the Bell Commission’s recommendation that residents not train in hospitals more than 80 hours a week—less than the 100 hours that were acceptable at the time. In 2003, the Accreditation Council for Graduate Medical Education stated trainees could work no more than 24 consecutive hours.

New regulations passed in 2011 reduced that even further to only 16 consecutive hours, because studies showed excessively long shifts lead to fatigue that increased risk of medical mistakes. But now, even though the hours have been cut, a recent study published in the Journal of the American Medical Association Internal Medicine shows that interns are making a greater number of mistakes than they were before.

Study finds reduced hours may lead to more doctor malpractice

Patients injured by doctor malpractice often cite physician fatigue or understaffed hospitals as liabilities. But according to this latest study, which involved 2,300 doctors from more than a dozen hospitals, trainees working under the current rules made medical mistakes 15-20% more often than their counterparts did under the old, longer-hour rules.

According to Time, Dr. Srijan Sen, a University of Michigan psychiatrist, said in a statement:“In the year before the new duty-hour rules took effect, 19.9% of the interns reported committing an error that harmed a patient, but this percentage went up to 23.3% after the new rules went into effect. That’s a 15 to 20% increae 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.”

In addition, the levels of depression among the interns remained the same, as did the amount of rest they were getting. The results suggested that something is still going wrong, as patient safety did not improve. Current data seems to suggest that reduced hours may do nothing to reduce medical malpractice cases.

New hours may not reduce medical malpractice cases

In speculating as to why the reduced hours had the opposite effect expected, researchers put forward some interesting theories:

  • Though interns are putting in fewer hours, they are still expected to accomplish the same amount of work. Trying to manage the same workload with less time could lead to increased errors.
  • Fewer work hours means that interns are “handing-off” patients more frequently to other doctors. The average number of hand-offs before the hour change was three in a single shift, and this has increased to as many as nine. Hand-offs increase risk for errors, as the new doctors are typically not as familiar with the patient’s history and may not be as personally invested in their care.

Researchers suggested requiring naps on the job, which may help sleepy doctors to improve performance.

New York medical malpractice lawyers can help

This study has some limitations, in that the data was reported by the residents themselves. Still, the results raise concerns about doctors’ abilities to properly diagnose, manage, and treat the patients in their care.

If you or a loved one suffered from a serious injury and you believe medical negligence or doctor malpractice may be to blame, contact the New York medical malpractice lawyers at The Sanders Firm. We are very familiar with the ramifications of doctor fatigue and stress, and can help you build a strong case. We offer a free initial consultation, and require no fees unless we win for you. Call us today. Resources

  1. Time,
  2. Washington Post,