AMA Doesn’t Think Tired Doctors Need Naps

Lean thinking means showing respect for people, both employees and customers. Equally important, it means looking at things from the customer’s point of view.

The American Medical Association just doesn’t get it.

I’m referring to the issue of how long doctors – specifically, residents – should be required to work, something I’ve written about before.

Residents have traditionally been required to work exhausting hours, and for too long the establishment has turned a blind eye to the problems that can result. A recent study reported in the AMA’s own journal found that complications are more likely when surgery is performed by surgeons who are sleep-deprived.

The Institute of Medicine has recommended that five-hour naps be mandatory for any hospital shift longer than 16 hours.

But now The Wall Street Journal Health Blog is reporting that the AMA is opposed to the mandatory naps.

At its recent meeting, the AMA adopted a new policy to oppose the guaranteed sleep time. Mandatory naps could “have significant unintended consequences for continuity of patient care and safety, as well as being difficult and expensive to implement and monitor,” the AMA’s recommendations say.

While the AMA may be raising legitimate concerns, these are problems to be overcome, not reasons to reject mandatory naps.

More to the point, the AMA is focusing on cost and continuity of care while ignoring the issue of quality of care – which is undoubtedly the chief concern of patients.

I suspect the AMA officials who are opposing the naps haven’t considered what it would be like to be a hospital patient confronting these issues. Would any of them want to be treated by a doctor who had been working for 30 hours straight? Somehow, I don’t think so.


Dean Bliss said...

This is one of many, many change management issues we deal with in health care - not unlike the issues that have been dealt with in manufacturing for the last 20 years. We're just getting started, and have a long way to go. I'm glad some of these things are getting surfaced so we can start to do something about them.

Robert said...

"The Institute of Medicine has recommended that five-hour naps be mandatory for any hospital shift longer than 16 hours."

Good heavens. If a truck driver or an airline pilot worked a shift that long and an accident resulted criminal charges would likely be considered. For that matter charges would likely be laid against the driver and his management even w/o an accident. Yet doctors are expected to exceed that as a matter of course.

I don't think The Institute of Medicine is being nearly aggressive enough in its recommendations. Unless, perchance, they have peer reviewed studies that show that doctors are less prone to fatigue than truck drivers and airline pilots.


Tim McMahon said...

If they regulate drivers in the transportation industry for safety why not other professions. I think we have all seen the studies showing the impact of tired people. This makes sense for most jobs. Safety should always come first.