Sleep Deprivation and Clinical Performance

Physicians' ability to provide high-quality care can be adversely affected by many factors,¹ including sleep deprivation. Concerns about the danger of physicians who are sleep deprived and providing care have led state legislatures and academic institutions to try to constrain the work hours of physicians in training (house staff).² Unlike commercial aviation, for example, medicine is an industry in which public safety is directly at risk but does not have mandatory restrictions on work hours. Legislation before the US Congress³ calls for limiting resident work hours to 80 hours per week and no more than 24 hours of continuous work. Shifts of residents working in the emergency department would be limited to 12 hours. The proposed legislation, which includes public disclosure and civil penalties for hospitals that violate the work hour restrictions, does not address extended duty shifts of attending or private practice physicians.