This article from the New York Times talks about the studies that have been done recently looking at the relationship between doctor fatigue and medical errors.
In 2003, a nationwide 80-hour per week limit was placed on doctors in training. These reforms were prompted by the death of an 18-year-old who died after being treated by a doctor who had be working for nearly 24 hours straight. In 2004, a study that looked at the correlation between long shifts for interns and medical errors found that those working long 30-hour shifts made 36 percent more mistakes than those limited to 16-hour shifts. A much larger study was published in 2009 that found no major difference in medical errors since the 2003 reforms. The author goes on to talk about the lack of solid evidence for the 80-hour limits reducing hospital errors. He describes how there are likely multiple issues at play, including a lack of sleep that are causing doctors in training to make errors.
The article provided a good example of the ruling out rival hypotheses and replicability scientific thinking principles. By focusing on only the amount of sleep that interns were getting, the medical community neglected to think carefully about the other factors that could be leading the errors, such as lack of supervision and decreased continuity of care that would result with the 80-hour rules. The 2004 study that found a strong correlation between long shifts and errors is a good example of the replicability principle. The study was relatively small and when a larger study was published in 2009, it found no improvement with reduced working hours. This shows the importance of not immediately accepting the conclusions of a study and highlights the pertinence of sample size for scientific studies. DARSHAK SANGHAVI
Sanghavi, D. (2011, August 5) The Phantom Menace of Sleep Deprived-Doctors. The New York Times. Retrieved October 7, 2011, http://www.nytimes.com/2011/08/07/magazine/the-phantom-menace-of-sleep-deprived-doctors.html?_r=1