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No adverse effects in patient safety, medical education in US seen with reduced work hours for doctors

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A systematic review published online in the British Medical Journal found that reducing doctors’ working time to less than 80 hours a week does not seem to adversely affect patient safety and has limited impact on post-graduate medical training in the United States, according to a press release.

The study, led by S. Ramani Moonesinghe, an anesthesiology consultant and honorary senior lecturer at the University College Hospital in London, and colleagues sought to evaluate the impact of work reduction on educational and clinical outcomes by reviewing 72 studies published in the United Kingdom and United States.

“The impact of reducing hours to less than 56 or 48 a week in the [United Kingdom] U.K. has not been sufficiently evaluated in high-quality studies,” the researchers wrote in their conclusion. “Further work is required, particularly in the European Union, using large, multicenter evaluations of the impact of duty hours’ legislation on objective educational and clinical outcomes.”

Of the studies Moonesinghe and colleagues reviewed, 38 reported on training outcomes, 31 noted patient outcomes and three studies reported on both types of outcomes, according to their abstract.

The maximum hours per week for trainees can range from 37 hours in Denmark to 80 hours in the United States. The European Working Time Directive, initiated in 2004, restricted the weekly training period for doctors in Europe to 48 hours. Since that time, there has been concern in the medical profession about potential adverse effects on postgraduate training for junior doctors and the provision of high-quality care for patients, according to the release.

The authors noted that more high-quality studies are needed to evaluate the impact of restricting work hours using objective measures of medical training and patient safety, particularly in the European Union, according to the release. “Only then can both the public and the profession be reassured that the standard of medical training, and therefore the future care of patients, is of the highest possible quality and will be maintained or improved over time,” they concluded.

Reference:

• Moonesinghe SR, et al. BMJ 2011; 342:d1580.

Disclosure: Moonesinghe has no relevant financial disclosures.

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