Sleep deprivation can affect surgeon’s ability to operate


Surgeons are highly respected individuals as they perform much needed surgeries that can be life saver for the patient.  The current medical system, allows surgeon to work round the clock without having much concern on how much sleep surgeon had.  There is a ongoing discussion to consider the sleep or work schedule of the surgeon and have him disclose that they had less sleep before performing the surgery.  Patient can decide and fill a consent form to go head with surgery on that day or postpone it for later. 

What is the basis of the surgeons to disclose number of hours slept?   
There have been studies, which exhibited that sleep deprivation can affect your cognitive functions and motor skills.  One study in specific was conducted on surgeons who performed elective day time surgery having less than six hour sleep between procedures due to previous on-call night.  The study revealed an 83% increase in risk of complications, such as massive hemorrhage, organ injury, or wound failure, in patients. 

What is the complication in sleep deprivation consent form?
There are two school of thought, one is that surgeons should reveal the number of hours they have slept in past 24 hrs before performing a surgery and then patient can decide whether he wants to go for surgery that day.  Another set of people think that physicians should be trained to recognize that they are not in position to operate because of lack of sleep.  Let us look at both the scenarios: 

Patient decides whether surgeon can operate or not

  • It puts burden on the patient and he might not be in a position to make decision, either he does not know enough or he might be afraid to spoil relationship with his surgeon
  • Also from the patient point of view, if a mistake happened during the procedure, it...

    becomes patients liability rather than physicians
  • Physiological condition of surgeon on the other hand can be affected by sleep and other personal problems like marriage issues.  Will the surgeon be asked to reveal all these to his patients?
  • At times, it is the hospital that puts surgeon on such tight schedule, how would this affect relationship of surgeon with the hospital.

Surgeon decides whether he is in position to operate

  • It would be difficult for surgeon to admit that he is not in a position to operate

What factors does the healthcare system consider for sleep deprivation?
The problem is complex.  It reminds me of the airline industry, wherein FAA regulation speaks that pilot should not be flying other plane, if he has not slept minimum of eight hours in last 24 hrs.  Medical community also needs a centralized policy that addresses the sleep deprivation issue of surgeons.  

MedPage Today revealed one more good point that there should be an objective measure of performance in the operating room; “the lack of awareness, denial, or lack of measured effect will keep from disclosure.” 

Though the situation is complex, but every healthcare industry, either service or manufacturing, is centered towards a common theme that patient safety is most important.  I think the healthcare industry should address the sleep deprivation of surgeons keeping this in mind and take a decision sooner than later. 

Source: MedPage Today


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