Utah Med Law

A recent study published and discussed in Medpage Today and HealthDay reveals some old and new information about doctors and how medical malpractice can occur.  The article, Fatigue, Distress Contribute to Resident's Errors, tells us that residents who report higher levels of fatigue, sleepiness and distress are at greater risk of committing medical malpractice (what the article terms (major medical errors).

Sleepiness was defined as driwsiness and lack of alertness.  Fatigue was defined as a wider sense of wariness and depletion of energy.  Now this is not new - many studies have reported that sleepiness and fatigue contribute to medical error.  I do not persoanlly think we needed study after study to showe us that sleepiness and fatigue do in fact contribute to error but there are those in the medical profession that claim that sleepiness and fatigue do not contribute to ewmedical error so I guess that formal studies were required.  It is common sense to me that when a physician is faced with many facts upon which to base a diagnosis that the correct analysis, at least in part, on the physician's attention to detail that is absent or lacking when the physician is sleep deprived. I have posted before about the long hours that doctors work and why they should be reduced.  

This most recent study piles on the evidence that doctors who are sleepy, fatigued and furthermore distressed are at higher risk for committing medical malpractice.  Distress focuses on such things as overall quality of life, depression and burnout which encompasses depersonalization, emotional depersonalization, emotional exhaustion and feelings of low accomplishment.  The results of this study suggests that fatigue and distress contribute to the risk of making medical errors and the odds ratios reportd "are of a magnitude relevant to patient safety." 

Past studies have been important to generate attention to the long hours worked by residents in training and has spurred the adoption of limitations to hours worked although theya re still disproportionate to other industries.  For example, airline pilots are restricted to flying no more than 30 hours per week and not longer than 8 hours per day.  Medical residents on the other hand are "limited" to more than 80 hours per week average over 4 weeks and no more than 24 hours per day - some restriction! 

In my career as a registered nurse I have seen hundreds of residents at teh University of Utah fall asleep while giving report, while I was reporting labvalues to them and during rounds.  Sleepiness, fatigue and distress are an epidemic in the education of physicians and are one of the reasons that medical malpractice occurs. 

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