Public Wants Well-Rested Medical Residents to Ensure Safe Patient Care

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A new national poll shows that the vast majority of the American public favors restricting the work shifts of medical residents (also known as resident physicians) to no more than 16 straight hours without sleep, according to a press release from Public Citizen.

Importantly, 86% of the public is opposed to lifting the 16-hour cap for first-year residents – a proposal being aggressively pushed by physician groups. Moreover, 80% of the public supports implementing the 16-hour cap for all residents, not just first-year residents.

“Sleep-deprived doctors must make life-or-death decisions while dealing with long overnight shifts,” said Arianna Huffington, author of “The Sleep Revolution.” “This latest poll shows that the American people want well-rested doctors treating them. When we take care of ourselves, we are more effective at taking care of others.”

The national poll, commissioned by Public Citizen and conducted by Lake Research Partners, was unveiled today during a telephone press conference. The poll comes as the Accreditation Council for Graduate Medical Education (ACGME) − the private organization that sets the rules on resident work hours that are intended to protect the health and safety of both residents and patients − is facing intense pressure from dozens of physician organizations to lift the current 16-hour shift cap for first-year medical residents and allow them to work 28 or more hours in a row without sleep, the press release notes.

“Rarely do we see such striking bipartisan consensus over any health care issue,” said Celinda Lake, president of Lake Research Partners. “The American public’s opinion toward medical resident work hours remains consistent and overwhelming: The vast majority of people do not want doctors-in-training treating patients after working grueling shifts of more than 16 hours without sleep.”

Numerous studies have demonstrated that residents commit more medical errors when working shifts of longer than 16 consecutive hours. Residents forced to stay awake for more than 16 consecutive hours also are at increased risk for needle-stick injuries, motor vehicle accidents and depression.

“The public’s apprehension about resident shifts longer than 16 hours comports with the long-standing evidence on the risks of long resident work shifts for both the residents and their patients,” added Dr. Michael Carome, director of Public Citizen’s Health Research Group. “Medical residents are not superhuman and, when sleep-deprived, put themselves, their patients and others in harm’s way. This is not a partisan political issue, but one of public health and safety.”

The poll also addressed the unethical FIRST and iCOMPARE trials, which have allowed many residency programs across the country to force first-year residents to work shifts of 28 consecutive hours or more – nearly twice the current maximum number of hours allowed by the ACGME. The researchers conducting these trials have not sought the consent of either the medical residents or the patients who are forced to be part of the experiments. Disturbingly, the ACGME − despite being made aware of the unethical nature of the trials − recently extended waivers of its work-hour rules to allow the continuation of both trials. When polled, 84 percent of respondents said they would want to be informed if they were admitted to a hospital that was participating in such trials and forcing first-year residents to work shifts of 28 or more hours.

Additionally, 84% of respondents would want to be treated by a different doctor if their own doctor had been working more than 16 consecutive hours without sleep.

In conjunction with the release of the poll findings, Public Citizen today is ramping up its campaign to protect patients and medical residents from dangerously long resident shifts by:

  • Issuing a report, “Bipartisan Consensus: The Public Wants Well-Rested Medical Residents to Help Ensure Safe Patient Care,” detailing the poll results and summarizing research conducted to date on the dangers of sleep deprivation in residents to both the residents and their patients;
  • Sending a letter cosigned by the American Medical Student Association (AMSA), along with the report, to the ACGME, urging it to listen to the American public and reject any call to roll back the 16-hour work-shift limit for first-year residents. The groups also urge the ACGME to apply the 16-hour cap to all residents and rescind waivers that allow the FIRST and iCOMPARE trials to continue;
  • Urging activists to email the ACGME and tell the accreditation group that they do not want their hospitals filled with sleep-deprived doctors;
  • Sending a letter cosigned by AMSA to the Office for Human Research Protections, presenting results of the poll questions related to the iCOMPARE and FIRST trials, and, once again, urging it to investigate both trials and suspend the iCOMPARE trial; and
  • Sending letters cosigned by AMSA to the lead institutions for the FIRST (Northwestern University) and iCOMPARE (the University of Pennsylvania, Johns Hopkins Bloomberg School of Public Health and Johns Hopkins Health System) trials urging them to terminate the trials.
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