Can health reporting in the popular press get any worse? Every time I think it has reached a new low in accuracy and reliability, somebody comes along and blows that last new low right out of the water.
Explore This IssueACEP News: Vol 32 – No 05 – May 2013
I have a dear friend who runs a news clipping service. From her base as a teacher of emergency medicine in Saginaw, Mich., she posts links to articles about issues in our health care system, some from trade publications (e.g., Health Affairs), many from the popular press. Knowing, as I do, that my friend is esteemed by her colleagues in academic emergency medicine and beloved by her trainees, when she posts something, I am much inclined to read it.
A recent article in USA Today stated that medical interns working shorter hours were making more mistakes. Citing a study published in a major medical journal, the article reported, “Most concerning: Medical errors harming patients increased 15% to 20% among residents compared with residents who worked longer shifts.”
I will admit to a dual bias here. First, I am naturally skeptical about anything that is counter-intuitive, and I was once a medical intern whose quality of decision making unquestionably deteriorated with sleep deprivation. Second, when I read something in the popular press about a medical study that doesn’t make sense, I naturally assume that the medical reporter got it wrong.
‘It only stands to reason thatin this climate, the perception of the occurrence of medical errors might increase, over time, without a change in the reality.’
In 1984 Libby Zion was a freshman at Bennington College. She got sick and was admitted to a New York hospital. A serious error was made in her medical care, and she died the next day. The error was thought to be due, at least in part, to long hours worked by medical residents. Sleep-deprived doctors are more likely to make bad decisions, or so thought the Bell Commission, whose recommendations to limit the hours of doctors in training were adopted by the state. Similar restrictions were adopted by the Accreditation Council for Graduate Medical Education (ACGME) in 2003.
Then in 2011 the ACGME further modified the work rules. One of the changes was to limit shift length for first-year residents (sometimes called interns) to 16 hours.
A study just published in the American Medical Association’s internal medicine journal examined the effects of this recent change by surveying medical interns before and after the 2011 change in the rules. Interns were asked about their work hours, how much sleep they were getting, their overall state of well-being, whether they were having symptoms of depression, and whether they thought they were making mistakes on the job.