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
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