Doctors and double shift
When average everyday employees are tired, it may affect their work productivity, efficiency, and under chronic conditions work fatigue can lead to mental exhaustion. When a medical doctor is tired, that’s a direct recipe for disaster that can lead to human error and casualties.
During residency training, doctors are required to work around the clock with more than 90 hours of weekly work, which add up to 15-16 hours of work a day, and very often with no days off.
In the second year of residency, doctors are being introduced to the double shift – a straight work shift of 26-32 hours with no sleep and inadequate eating breaks. A doctor who has not slept for more than 26 hours risks the patients’ health, his or her own health, and the well-being of others on the road back home. A negative cycle of human error is created due to a lack of sleep and recovery.
Interestingly, the medical residency of the American medical training system is an international concept that almost every developed country has adopted.
Dr. William Stewart Halsted
Medical residency is a training method that was invented 100 years ago by the well-credentialed doctor named William Stewart Halsted, an American surgeon who has often been called the Father of Modern Surgery. Dr. William Stewart Halsted was an extraordinary doctor, but he was also a cocaine addict, which was not an illegal drug in those days.
Cocaine is a powerful drug that can keep you awake for longer hours and even for days in high function, without the need to sleep or eat. In addition, it causes the users to feel and believe that they are capable of more than they actually are, and it is highly addictive.
Dr. William Stewart Halsted, who consumed daily doses of potent stimulants, was the person to determine that doctors should work double shifts. Thus, it is surprising that 100 years later, doctors are still expected to work the same amount of hours as was the norm back then but without snorting or injecting any drugs. From all perspectives, the double shift in hospitals is a health-risking event both to patients and doctors.
Many physicians would argue that this is the only way to practice medicine and that the road to pursue the medical profession needs to be demanding, sometimes at the cost of affecting their own physical and psychological health. Unfortunately, as a result, the mental health status of our doctors is not in a good state. It is a global trend around the world where doctors at all levels of experience have given up their lives due to the inability to balance the intense work required in hospitals.
In general, most doctors start their academic medical years with a genuine passion for caring for others. Prestige and other superficial concerns cannot hold up enough to maintain the motivation and discipline needed to continue pursuing a medical career; it is too difficult. Thus, to allow our doctors to be better health providers, we also need to be aware of their mental health and to acknowledge their needs as human beings.
It is hard to change a medical practice tradition in existence for over 100 years, but we can start by taking care of our physicians. Doctors can sometimes see more than 50 patients a day, performing 5-6 surgeries a day, and it all needs to be done most professionally. With the lack of proper sleep and extreme mental fatigue, patience, kindness, and appreciation would give the doctors the fuel required to continue their day.
The health system should still fight to reduce the number of hours and to improve the work conditions of the doctors in residency training. Both sides can benefit from such an act; functional productivity, along with the general health of doctors, is expected to increase.