Medical mistakes

by on January 14, 2005 at 5:44 pm in Medicine | Permalink

More people die from medical mistakes each year than from highway accidents, breast cancer, or AIDS and yet physicians still resist and the public does not demand even simple reforms. 

The New England Journal of Medicine, for example, has just published another study, as if we needed it, showing that interns who are kept awake for 30 hours straight
are a danger to themselves and innocent bystanders as well as to patients:

Researchers found that interns more than doubled their risk of getting into a
car accident after being on call, a stint that meant working for 32 consecutive
hours with only two or three hours of sleep, on average. Interns were also
nearly six times as likely to report nearly having an accident on their way
home.

….The researchers say those limits don’t give doctors enough time to sleep.
A study published last fall, also in the New England Journal, found that interns
who spent every third night working in the intensive care unit made 36% more
medical errors than interns who kept less onerous schedules. They also made
serious diagnostic errors 5.6 times as often as their well-rested counterparts,
the study found.

I will just quote Kevin Drum on this:

I’ve heard a litany of defenses of this practice from senior medical folks,
and they couldn’t sound more lame if they tried. They sound like nothing so much
as a bunch of 50s frat boys defending hazing after some freshman has been found
dead in an arroyo somewhere.

It’s unbelievable that this system has continued as long as it has and
unbelievable that it continues to be defended. Do we really need studies to tell
us that people who have been awake for 30 consecutive hours probably aren’t
making very good decisions? And that both patients and others are suffering from
this?

Would you want your mother to be looked after by a trainee who’s been
on her feet for 30 hours? I wouldn’t.

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