Comments on: Time for a nap http://www.medrants.com/archives/4274 Contemplating medicine and the health care system Wed, 17 Mar 2010 23:16:37 +0000 http://wordpress.org/?v=2.9.2 hourly 1 By: v http://www.medrants.com/archives/4274/comment-page-1#comment-527067 v Sun, 24 May 2009 04:09:01 +0000 http://www.medrants.com/?p=4274#comment-527067 There is over forty years worth of research on the effects of sleep on performance (for example, the work of people like Dr. Charles Czeisler at the Brigham and many many others) and so it is not exactly persuasive to oppose work hours rules on that basis. Moreover, given that professions with similar effects on public safety like airline pilot, nuclear energy technician, etc. all have much stricter limits than 80 hours, perhaps the better question is why would the burden of proof be on the IOM or ACGME... If resident education is adversely effected (or more likely, hospital finances given that they would have to pay for cheap labor replacement), then that should be where critics should be focusing their energies on trying to improve rather than making weak claims about inadequate research... NEJM also should be ashamed of failing to mention the fact that in Europe strict work hours limitations have been implemented without much of the whining and none of the adverse effects on patient care that people keep theorizing about... There is over forty years worth of research on the effects of sleep on performance (for example, the work of people like Dr. Charles Czeisler at the Brigham and many many others) and so it is not exactly persuasive to oppose work hours rules on that basis. Moreover, given that professions with similar effects on public safety like airline pilot, nuclear energy technician, etc. all have much stricter limits than 80 hours, perhaps the better question is why would the burden of proof be on the IOM or ACGME…

If resident education is adversely effected (or more likely, hospital finances given that they would have to pay for cheap labor replacement), then that should be where critics should be focusing their energies on trying to improve rather than making weak claims about inadequate research…

NEJM also should be ashamed of failing to mention the fact that in Europe strict work hours limitations have been implemented without much of the whining and none of the adverse effects on patient care that people keep theorizing about…

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