Sleep Deprivation and Performance of Residents-Reply

In Reply.—  Sleep deprivation and resident performance is a sensitive topic and we realize that the results of our study may not please all. We sought to document decrements in performance due to being on call and were prepared to find the assumptions bruited in the media to be correct. We found otherwise. Corroboration or invalidation of our findings requires independent study by others. This is the real challenge to many of our correspondents.Physician sleep deprivation is a complex issue in which objectives relating to patient care appear to be in conflict. Patients expect their physician to respond whenever they are in need and, further, to continue to provide care throughout their illness. Patients also expect physicians to deliver care that meets accepted standards. Does loss of sleep in fulfillment of the first expectation impair fulfillment of the second? What parameters define a balance between these commitments to which