The Complex Relationship Between Doctor-Intern Work Hours and Medical Malpractice

Patient safety advocates frequently explain that anywhere from 100,000 to 200,000 patients die each and every year in the U.S. as a result of preventable medical errors. Placed in context, this means that medical mistakes are the third leading cause of death in the country behind only heart disease and cancer. With those staggering numbers it is imperative that medical professionals, hospital administrators, and others involved in the industry do everything in their power to change policy, enact safeguards, and ensure all medical patients receive quality care every time they enter a facility.

In recent years advocates have discussed how work hours may impact error rates. Many doctors, particularly new intern-doctors, are required to put in significant work time week after week. These overworked professionals may be more likely to get insufficient sleep with harmful effects on their critical thinking ability. Lapses in judgement, cut corners, and oversights are more likely when that happens.

New Medical Education Requirements
In 2011, in response to worry about work hour effects on medical errors, the Accreditation Council for Graduate Medical Education made changes to the maximum continuous work hours for first-year intern-doctors. The cap was set at 16 continuous hours, which limited the average intern work week from 67 hours to 64 hours. The idea was that this decrease would ultimately improve patient safety and minimize medical malpractice.

Because intern doctors are the least experienced professionals, they often have higher error rates. Adding stress, burnout, and insufficient sleep to that inexperience is often a recipe for problems–as many patients have discovered over the years.

A new study was just released this March which examined the possible effects of the 2011 change in work hours. The findings are somewhat mixed, serving as a reminder of the complexity in making system-wide changes to prevent errors. As discussed in an Anesthesiology News article this week, the study (viewed in full here) included surveys of intern-doctors affected by the rule change. The effort did not directly test whether lower hours resulted in fewer medical errors, but it did assess other factors which likely contribute to patient safety.

For example, interestingly, the researchers discovered that since the change more interns than before were consciously afraid of making a mistake. That itself may be a good thing, simply representing an increased awareness of the need to be cautious at all times.

Alternatively, the study also found, unsurprisingly, that the hourly change led to more patient handoffs between doctors. These handoffs can be dangerous times for patients, particularly if the new doctor is not kept up to speed on the patient’s condition and risk factors. When communication breaks down between doctors in these situations, there may be a delayed response to deteriorating patient condition which leads to preventable harm.

At the end of the day, it is important for all Maryland families to remember that, regardless of the underlying issues, when they receive substandard medical care that causes harm, they are entitled to fair compensation for their losses. The medical malpractice attorneys of Brassel, Alexander & Rice, LLC have been affected by these errors. Feel free to contact our legal team today.