Sleep Disorder Clinics across North America continue to compile statistics indicating that lack of sleep can severely impair judgment and the ability for people to function properly. And yet, it would appear that the health care professionals who should both know and act upon this knowledge first, are the worst offenders when it comes to sleep deprivation. When doctors tell us of their finding relating to people’s sleep needs, they tend to mention truck drivers, airline pilots and other professionals performing public services because this is where lives are at stake. But what about doctors themselves?
In North America at least, there seems to be an unwritten rule that doctors need to function at least twenty hours of every day. Although it has been proven otherwise, they seem to think that if they do this long enough, their bodies will somehow adapt and become used to it. From the time they are in medical school to the time they complete their residencies, doctors in training are worked off their feet. Often they are on-call and need to be prepared to go into the hospital for an ‘all-nighter’ after having worked all day. Then they are expected to function the following day on a half hour nap.
Although it is not a part of any written code, it would appear that sleep deprivation is a part of every doctor’s rite-of-passage. That’s the way it has been historically and it continues to be. This however, leads to the question: why doesn’t somebody do something about it?
Just because there is some “macho” thing happening amongst physicians, this does not mean that I want to settle for the services of a doctor or resident who’s been on his feet for the past twenty-four hours. Just as I would not want to be driven anywhere by an intoxicated taxi driver even though he’s a professional, neither would I want to be helped by a doctor who can barely open his or her eyes. And yet, this is commonly occurring in Emergency Rooms across the nation. Especially where there are doctor shortages, ER shifts can be twelve hours long, and then extended hours beyond that.
In other parts of the world, the doctor to patient ratio is lower and the quality of care does not suffer for it. There are doctors coming to America from various parts of the world with credentials and talents comparable to those of American trained doctors. Though some parts of the world lag behind America when it comes to the quality of health care, this often relates to technology more than anything else.
The problem in America seems to lie in monetary expectations of the medical profession establishment. It stands to reason that if the number of physicians is kept low, the demand on these physicians will be great, as will their income earning capacity.
Only in America, from what I’m told by physicians from around the world, is there an unwarranted mythology built around doctors. They have been elevated to a god-like status because they are the ones who can hold the power of life or death over people whose lives they are entrusted with. But does this mean that we have to continue to buy into the thirty-six hour shift life-style of doctors as portrayed on television shows such as “House”? Doctors, after all, are only human too. When they are sleep-deprived, they tend to make more mistakes just like everyone else. Isn’t it time we started to rethink the whole business of how we train doctors and how many we hire in order to give them decent working hors?