Doctors' working hours: can the medical profession afford to let the courts decide what is reasonable?

  title={Doctors' working hours: can the medical profession afford to let the courts decide what is reasonable?},
  author={Antony Nocera and Diana Strange Khursandi},
  journal={Medical Journal of Australia},
The pattern of long work days followed by nights interrupted by calls is regarded as normal by the medical profession. These calls are, at best, simple telephone calls. At worst, they may entail returning to the hospital several times a night. Few other workers do this, and data on its long-term effects are entirely lacking. Being on-call impairs sleep even when there are no calls, II and as five or six hours' uninterrupted sleep is needed to avoid performance decrement'? perpetual or frequent… 

Safe working hours--doctors in training a best practice issue.

  • A. Lewis
  • Political Science, Medicine
    Australian health review : a publication of the Australian Hospital Association
  • 2002
Public hospitals often maintain the view that minimal budget flexibility restricts their capacity to affect change in a positive way, but in fact devisable productivity and efficiency gains can be achieved by reducing working hours.

Working to Death: The Regulation of Working Hours in Health Care

Differences in the instruments used to regulate the issue in these countries and in the economic, social, and cultural factors that limit instrument choice and moderate instrument effectiveness are demonstrated.


Assessment of the relationship between demanding work schedule and job performance of health care unit personnel in West Bengal found that the nature of job demand in night shift is more in psychological domain rather than the physiological one due to disruption of biological rhythms.

Rest during shift work in the emergency department.

A program to encourage shift breaks for emergency department doctors and analyse the effects of breaks on tiredness and fatigue as well as possible effects on overall departmental performance found significant improvements in some key performance indicators.

Electronic medical handover: towards safer medical care

An electronic handover system is a potential solution, but the survey shows that free‐text entry into such systems may be inadequate; prompts or predefined fields for handover content are possible solutions.

Identification of Nurses’ Errors in the Emergency Ward, Using SHERPA Technique

Overall, the action errors and the checking errors should be priority in controlling and reducing of nurses errors in emergency ward.

Doctors' Stress Responses and Poor Communication Performance in Simulated Bad-News Consultations

BBN was a stressful experience for doctors even in a simulated encounter, especially for those who were inexperienced and/or fatigued, and factors associated with high stress levels and poor communication performance during a simulated BBN task were determined.

Pharmacist's attitudes towards dispensing errors: their causes and prevention.

D Dispensing errors are occurring in numbers well above reports to regulatory authorities or professional indemnity insurance companies, and seem to be accepted as part of practice.

Preventing iatrogenic Complications

There is a growing understanding that medical error as a subset of iatrogenic disease, represents a failure of the system, not just the individual, and the prevention of error therefore requires a systems approach.



The impact of long working hours on resident physicians.

  • T. Mccall
  • Medicine
    The New England journal of medicine
  • 1988
Even without long hours, residency training would be stressful for house officers, who often find there is more work to do than time to do it.

Sued and nonsued physicians' self-reported reactions to malpractice litigation.

Sued physicians reported significantly more symptoms than nonsued physicians, and were more likely to stop seeing certain types of patients, think of retiring early, and discourage their children from entering medicine.

Extended workshifts and excessive fatigue

  • R. Rosa
  • Business
    Journal of sleep research
  • 1995
It is concluded that extended workshift schedules should be instituted cautiously and evaluated carefully, with appropriate attention given to staffing levels, workload, job rotation, environmental exposures, emergency contingencies, rest breaks, commuting time, and social or domestic responsibilities.

Neurobehavioral effects of the on-call experience in housestaff physicians.

Sixty-tree medical residents were tested on a battery of computer-based, self-administered neurobehavioral tests before and after a 36-hour in-hospital call plus postcall day to assess the central

Sleep deprivation and resident performance.

The assumption that sleep deprivation associated with usual on-call schedules impairs cognitive and motor performance of residents such that clinical care of patients may be compromised is not supported by the authors' observations.

Effects of timing of shifts on sleepiness and sleep duration

The results from the few studies available show that sleep duration is clearly determined by the change over time between the night and the morning shift—no more than 5 or 6 hours of sleep is obtained before the morningshift if the shift starts at 06.00 hours or earlier.

Speed and direction of shift rotation

  • P. Knauth
  • Business
    Journal of sleep research
  • 1995
To minimize the disturbances of the circadian system and the accumulation of sleep deficits, rapidly and clockwise‐rotating shift systems would seem to be preferable.

Fatigue, alcohol and performance impairment

The performance impairment caused by fatigue is compared with that due to alcohol intoxication, and it is shown that moderate levels of fatigue produce higher levels of impairment than the proscribed level of alcohol intoxication.

Long-term adjustment of circadian rhythms to a rotating shiftwork schedule.

  • K. Dahlgren
  • Psychology
    Scandinavian journal of work, environment & health
  • 1981
Results showed that after 3 a of experience the awake temperature curves had a flattened shape in connection with both the beginning and end of the nightshift week and also during the free days, during sleep there was however a short-term adjustment of the temperature curves within the night shift week.