Over-tired doctors 'putting patients at risk'

Patient safety is being put at risk by exhausted doctors, some of whom are working more than 70 hours a week, new research has found.

A Massey University survey of 1366 junior doctors found that four out of 10 had made a fatigue-related medical error over a six-month period.

Nearly half (42 per cent) admitted having fallen asleep at the wheel driving home from work.

The majority reported work patterns caused problems in their personal life.

Lead researcher and director of the university's Sleep/Wake Research Centre Philippa Gander said twice as many doctors rated as "excessively sleepy" on a standard test compared with the general population.

"The reported levels of sleepiness, fatigue-related clinical error, and problems outside work caused by work patterns are all of concern, for the safety and wellbeing of doctors and patients."

The longer the hours they worked, the more problems they reported.

Some doctors reported working more than 70 hours a week.

Professor Gander said night work and irregular shift patterns, including long night hours, made it more difficult to set proper sleep patterns.

Last month, the Health and Disability Commission spoke out against rostering practices in public hospitals, after an exhausted rural doctor took 12 hours to diagnose a serious condition.

A 15-year-old boy lost a testicle after the on-call doctor, who had worked 60 hours in the previous three days because of a doctor shortage, deferred seeing him until morning and then missed key symptoms.

Speaking earlier this year, sleep researcher Heather Purnell said medical students received minimal training on sleep at medical school, either in relation to their patients' needs, or to coping with their own work demands.

"That concerns me, because achieving a balance between demanding work patterns and the rest of your life depends on understanding circadian rhythms and the effects of sleep restriction," she said.

"For example, our study found that for many resident medical doctors (RMOs), work patterns had a high impact on social life, home life, personal relationships, and other commitments."

The Health and Safety in Employment Act 1992 was extended in 2003 to cover stress and fatigue as identifiable workplace hazards.

The problem is not limited to New Zealand.

In Europe a working time directive will reduce doctors' working hours to a maximum 48 per week by 2009, from the current maximum of 58 hours.

- NZPA