Summary: 12/4/08 11:37 PMDoctor and Patient - Does More Sleep Make for Better Doctors? - NYTimes.com
Page 1 of 4http://www.nytimes.com/2008/12/05/health/05chen.html?pagewanted=print
December 5, 2008
DOCTOR AND PATIENT
Does More Sleep Make for Better Doctors?
By PAULINE W. CHEN, M.D.
This week a national panel of health care experts released a report affirming the current mandate
that limits the workweek for medical residents to 80 hours and offering additional
recommendations to decrease fatigue for doctors-in-training.
The report, "Resident Duty Hours: Enhancing Sleep, Supervision, and Safety," from the Institute
of Medicine, encourages graduate medical education programs to embrace a new culture of
training, one that emphasizes patient safety and the importance of sleep. It's an impressive
assessment, at 480 pages, but reading through it I could not help but wonder if in our attempts to
solve one set of problems, we will find ourselves facing another.
It reminded me of an aphorism I think of each time I prescribe or operate: every treatment is a
double-edged sword. The aspirin that relieves pain can cause intractable bleeding; the
chemotherapy that arrests cancer can carry debilitating side effects; and the operation that
replaces diseased livers requires toxic immunosuppressive drugs.
Even the best attempts at cure do not come without strings attached.
Residency training, the three to seven or more years following medical school, has historically