Surgeons urged to disclose sleepiness and fatigue level prior to operations

Surgeons urged to disclose sleepiness prior to operations

Surgeons should tell patients if they have not slept well and preclude themselves from performing an operation unless a written consent is given by the patient, according to an editorial by researchers published in the December 30 issue of the New England Journal of Medicine. The editorial says that based on surveys, most patients would opt for an alternative surgeon if they knew that their original provider lacked sleep. Presently, there are no concrete rules about the length of time fully-trained surgeons can work in any given day. The proposal's aim is for facilities not to proceed with an operation when the surgeon did not have enough sleep to limit mistakes and achieve optimal performance. "This approach would represent a fundamental shift in the responsibility patients are asked to assume in making decisions about their own care and might prove burdensome to patients and physicians, and damaging to the patient-physician relationship," the researchers wrote, adding that such a proposal may be enforced in the absence of a formal rule in a surgical facility regarding the problem. Lack of sleep has been shown in many studies to weaken psychomotor skills much like what alcohol does to the body. This can raise the risk of complications in patients undergoing surgery if the doctor suffers from sleep deprivation.

"Sleep deprivation affects clinical performance. It increases the risks of complications," said co-author Dr. Michael Nurok, anesthesiologist and intensive care doctor at the Hospital for Special Surgery in New York City, in a news release. "And it is clear from survey data that patients would want to be informed if their physician was sleep-deprived and that most patient would request a different provider." Some hospitals try to implement a scheduling mechanism where the dilemma can be avoided. But the authors acknowledge that many facilities will be hard-pressed to implement such a policy change.

Posted by George Daniels on Thursday December 30 2010, 2:32 AM EST. Ref: Business Week. All trademarks acknowledged. Filed under Featured News, Health. Comments and Trackbacks closed. Follow responses: RSS 2.0