Sydney Research Institute raises concerns about sleepy doctors

Apr 27 2005

Professor Ron Grunstein, Head of the Sleep and Circadian Research Group and Dr Naomi Rogers, chronobiologist both of the Woolcock Institute of Medical Research, have questioned the ability of doctors in Australia's hospitals to do their job properly given the long hours many are expected to work.

In an article published in the latest Internal Medicine Journal, Professor Grunstein not only recommends the medical profession closely monitors the hours its young doctors work but also warns there is evidence of a harsher legal climate for sleep deprived doctors who continue to work and potentially put patients safety at risk.

Citing data from a recent study by the Division of Sleep Medicine at Harvard University Professor Grunstein says evidence suggests that lack of sleep increases the incidence of medical errors.

The Harvard study found this to be particularly evident in the higher number of medication errors and diagnostic errors made by intern doctors working a traditional shift (an average of 85 hours per week) schedule, said Professor Grunstein.

With up to 15% of Australia's medical practitioners working over 80 hours per week, the findings of this study are something we ought to take seriously, he said.

Professor Grunstein compares sleep related errors in medicine with road accidents resulting from people falling asleep at the wheel.

Society and its legal systems are increasingly less tolerant of dangerous drivers escaping punishment due to fall asleep defences, he said, believing that for most people it is foreseeable, avoidable and an act of criminal recklessness.

I predict that if the medico-legal implications of the information resulting from the Harvard study are ignored, it will only be a matter of time before a law is introduced making it very difficult for doctors to blame lack of sleep for mistakes.

Dr Peter Cistulli, President of the Australasian Sleep Association, backs Professor Grunstein and the Woolcock Institute's concerns.

The association wholeheartedly supports a review of work hours and a need for monitoring work hours in the medical profession, said Dr Cistulli.

The impact of shift work and long hours on sleep are becoming better recognised in many industries in Australia. It is important for the medical sector to address this issue before employee sleep loss reaches dangerous levels.