A recent study (KY Bilimoria et al. NEJM 2016; DOI: 10.1056/NEJMoa1515724) indicates that some flexibility in training hours did not result in increased adverse outcomes and improved continuity of care. This study examined the care of nearly 140,000 patients.
For a 2 minute quick take -video available at this link along with full-text and abstract: National Cluster-Randomized Trial of Duty-Hour Flexibility in Surgical Training
Related blog posts:
In September, this blog (Does Staying Up All Night Affect Surgery the Next Day …) noted a recent study indicating that adverse surgical outcomes with elective daytime procedures were similar irrespective of whether the surgeon had operated overnight. Some of the letters to the editor on this study were of interest. In one, the authors note that sleep deprivation was associated with a lower adenomatous polyp detection rate on colonoscopy but was not associated with major complications like death or perforation (M Benson et al. Am J Gastroenterol 2014; 109; 1133-7). Thus, the letter contends that there are likely to be subtle effects of sleep deprivation on physician performance that could require more sensitive quality metrics.
Another letter notes that extended work was associated with an increased risk of motor vehicle accidents by interns. The monthly risk increased 16.2% for every extended work shift (LK Barger et al. NEJM 2005; 352: 125-34). Thus, sleep deprivation could represent a hazard for the physician themselves as well as their patients.
My take: I’m sorry I didn’t quite follow this post. (I was on-call last night.)
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