Attending physician work hours: ethical considerations and the last doctor standing.

Mark R Mercurio; Steven M Peterec

Commentary

Attending physician work hours: ethical considerations and the last doctor standing.

July 29, 2009

Mercurio MR, Peterec SM. Pediatrics. 2009;124(2):758-62.

View more articles from the same authors.

Discussing inconsistencies in work-hour limits for physicians-in-training and attending physicians, this commentary suggests that long work hours for attending physicians could be similarly unsafe for patients.

PubMed citation

Available at

Related Resources From the Same Author(s)

Improving the quality of health care: what's taking so long?

October 23, 2013

The aging surgeon.

September 7, 2016

Simulation study of rested versus sleep-deprived anesthesiologists.

January 9, 2005

High-reliability health care: getting there from here.

October 2, 2013

Aiming higher to enhance professionalism: beyond accreditation and certification.

May 27, 2015

The ongoing quality improvement journey: next stop, high reliability.

April 20, 2011

The wrong patient.

March 27, 2005

Electronic prescription writing errors in the pediatric emergency department.

June 24, 2015

Improving hand hygiene at eight hospitals in the United States by targeting specific causes of noncompliance.

January 14, 2015

Missed steps in the preanesthetic set-up.

April 27, 2011

Assessing the performance of aging surgeons.

January 30, 2019

The evolving role of health educators in advancing patient safety: forging partnerships and leading change.

April 11, 2007

Patient safety in home hemodialysis: quality assurance and serious adverse events in the home setting.

June 3, 2015

Errors, near misses and adverse events in the emergency department: what can patients tell us?

November 5, 2008

Opioid prescribing patterns among medical providers in the United States, 2003-17: retrospective, observational study.

April 8, 2020

Pain states, the opioid epidemic, and the role of radiologists.

April 4, 2018

Accountability measures—using measurement to promote quality improvement.

June 30, 2010

Risk factors for retained surgical items: a meta-analysis and proposed risk stratification system.

August 13, 2014

Assessing resident safety culture in nursing homes: using the nursing home survey on resident safety.

December 2, 2009

Hospital performance trends on national quality measures and the association with Joint Commission accreditation.

October 26, 2011

Using the Targeted Solutions Tool to improve hand hygiene compliance is associated with decreased health care–associated infections.

April 6, 2016

Inappropriate medication use in the elderly: results from a quality improvement project in 99 primary care practices.

April 23, 2008

Sins of omission. Getting too little medical care may be the greatest threat to patient safety.

July 6, 2005

Association of hospital participation in a regional trauma quality improvement collaborative with patient outcomes.

June 20, 2018

Organizational climate determinants of resident safety culture in nursing homes.

July 20, 2011

Professional behavior and value erosion: a qualitative study of physicians and the electronic health record.

November 9, 2022

Exploring barriers and facilitators to the use of computerized clinical reminders.

April 21, 2005

Identifying barriers to the effective use of clinical reminders: bootstrapping multiple methods.

June 1, 2005

Use of an emergency manual during an intraoperative cardiac arrest by an interprofessional team: a positive-exemplar case study of a new patient safety tool.

August 15, 2018

Ambiguity and workarounds as contributors to medical error.

April 27, 2005

Sleep, sleepiness, fatigue, and performance of 12-hour–shift nurses.

August 3, 2016

Opioid abuse and poisoning: trends in inpatient and emergency department discharges.

November 1, 2017

Medication safety in primary care practice: results from a PPRNet quality improvement intervention.

July 11, 2012

Implementing computerized provider order entry in acute care hospitals in the United States could generate substantial savings to society.

August 5, 2015

Medical diagnoses commonly associated with pediatric malpractice lawsuits in the United States.

December 17, 2008

Clinical and financial implications of second-opinion surgical pathology review.

April 7, 2021

Intended and unintended effects of large-scale adverse event disclosure: a controlled before-after analysis of five large-scale notifications.

April 29, 2015

Comparison of quality of care for patients in the Veterans Health Administration and patients in a national sample.

March 6, 2005

From implementation to sustainment: a large-scale adverse event disclosure support program generated through embedded research in the Veterans Health Administration.

August 18, 2021

The Research on Adverse Drug Events and Reports (RADAR) project.

May 18, 2005

The association of nursing home characteristics and quality with adverse events after a hospitalization.

April 28, 2021

Using improvement science methods to increase accuracy of surgical consents.

September 17, 2014

The computerized rounding report: implementation of a model system to support transitions of care.

August 3, 2011

American College of Surgeons' Committee on Trauma performance improvement and patient safety program: maximal impact in a mature trauma center.

December 14, 2011

Vulnerability of the medical product supply chain: the wake-up call of COVID-19.

November 25, 2020

Absence or presence: silent discourse in the operating room and impact on surgical team action.

November 11, 2020

Mortality among patients with acute myocardial infarction: the influences of patient-centered care and evidence-based medicine.

October 13, 2010

Potentially inappropriate medication use is associated with increased risk of incident disability in healthy older adults.

September 6, 2023

Clinical reasoning education at US medical schools: results from a national survey of internal medicine clerkship directors.

September 13, 2017

Transferring aviation practices into clinical medicine for the promotion of high reliability.

July 26, 2017

Critical events in the lives of interns.

November 19, 2008

Natural history of retained surgical items supports the need for team training, early recognition, and prompt retrieval.

September 24, 2014

Seasoned surgeons assessed in a laparoscopic surgical crisis.

May 13, 2009

Improving healthcare systems' disclosures of large-scale adverse events: a Department of Veterans Affairs leadership, policymaker, research and stakeholder partnership.

November 19, 2014

Retained surgical items: a problem yet to be solved.

October 31, 2012

Risk factors for hospital admissions associated with adverse drug events.

August 28, 2013

Transforming the medication regimen review process using telemedicine to prevent adverse events.

December 16, 2020

Rates of adverse events in hospitalized patients after summer-time resident changeover in the United States: is there a July effect?

August 25, 2021

Taking patients' narratives about clinicians from anecdote to science.

August 19, 2015

Americans' growing exposure to clinician quality information: insights and implications.

March 20, 2019

Challenges with implementing the Centers for Disease Control and Prevention opioid guideline: a consensus panel report.

April 3, 2019

American College of Endocrinology and American Association of Clinical Endocrinologists position statement on patient safety and medical system errors in diabetes and endocrinology.

December 7, 2005

Do work condition interventions affect quality and errors in primary care? Results from the Healthy Work Place Study.

September 28, 2016

A cluster randomized trial of interventions to improve work conditions and clinician burnout in primary care: results from the Healthy Work Place (HWP) study.

January 27, 2016

Using failure mode and effects analysis to plan implementation of smart i.v. pump technology.

August 23, 2006

Procedural timeout compliance is improved with real-time clinical decision support.

September 12, 2018

What words convey: the potential for patient narratives to inform quality improvement.

April 24, 2019

The importance of preparation for doctors' handovers in an acute medical assessment unit: a hierarchical task analysis.

February 29, 2012

Development of a Web-based surgical booking and informed consent system to reduce the potential for error and improve communication.

February 26, 2014

Sleep deprivation: implications for obstetric practice in the United States.

August 26, 2009

Hospital progress in reducing error: the impact of external interventions.

April 9, 2008

A medical error leads to tragedy: how do we inform the patient?

November 8, 2006

Fixing healthcare from the inside, today.

September 28, 2005

Optimizing smart pump technology by increasing critical safety alerts and reducing clinically insignificant alerts.

March 18, 2015

Using smart pumps to understand and evaluate clinician practice patterns to ensure patient safety.

February 12, 2014

How might acknowledging a medical error promote patient safety?

October 18, 2006

Quality: performance improvement, teamwork, information technology and protocols.

April 17, 2013

Closed medical negligence claims can drive patient safety and reduce litigation.

April 4, 2012

Medication discrepancies in integrated electronic health records.

December 12, 2012

Patient care, square-rigger sailing, and safety.

October 22, 2008

Managing health IT risks: reflections and recommendations.

June 13, 2018

An organisation without a memory: a qualitative study of hospital staff perceptions on reporting and organisational learning for patient safety.

November 18, 2015

Patient safety records: silent witness.

October 1, 2008

Improving hospital safety culture for falls prevention through interdisciplinary health education.

December 23, 2020

Reframing and addressing horizontal violence as a workplace quality improvement concern.

August 22, 2018

Medication errors: how reliable are the severity ratings reported to the National Reporting and Learning System?

September 23, 2009

Quality improvement as a primary approach to change in healthcare: a precarious, self-limiting choice?

December 7, 2022

A vision for patient-centered health information systems.

January 26, 2011

Interprofessional conflict and medical errors: results of a national multi-specialty survey of hospital residents in the US.

December 10, 2008

Danger in discharge summaries: abbreviations create confusion for both author and recipient.

May 31, 2023

Fatigue among clinicians and the safety of patients.

March 6, 2005

A systems approach to patient-centered care.

January 3, 2007

Operational failures and interruptions in hospital nursing.

June 14, 2006

Patient safety: mindful, meaningful, and fulfilling.

October 19, 2005

Context matters: toward a multilevel perspective on context in clinical reasoning and error.

June 21, 2023

Patient safety and leadership: do you walk the walk?

May 3, 2017

Correlates of the third victim phenomenon.

April 12, 2017

The incidence of diagnostic error in medicine.

August 14, 2013

A novel tool for organisational learning and its impact on safety culture in a hospital dispensary.

June 20, 2012

Eight-year experience with a neurosurgical checklist.

August 18, 2010

Related Resources

Impact of medical education on patient safety: finding the signal through the noise.

February 8, 2023

National improvements in resident physician-reported patient safety after limiting first-year resident physicians' extended duration work shifts: a pooled analysis of prospective cohort studies.

May 25, 2022

Leadership through crisis: fighting the fatigue pandemic in healthcare during COVID-19.

March 31, 2021

Patient Safety Primers

Fatigue, Sleep Deprivation, and Patient Safety

September 7, 2019

Associations between in-hospital mortality, health care utilization, and inpatient costs with the 2011 resident duty hour revision.

May 15, 2019

The 2017 ACGME common work hour standards: promoting physician learning and professional development in a safe, humane environment.

January 31, 2018

Fatigue risk management: the impact of anesthesiology residents' work schedules on job performance and a review of potential countermeasures.

December 13, 2017

Ethical considerations in the development of the Flexibility in Duty Hour Requirements for Surgical Trainees trial.

October 26, 2016

Caregiver fatigue: implications for patient and staff safety—part 1 and part 2.

September 7, 2016

A reduced duty hours model for senior internal medicine residents: a qualitative analysis of residents' experiences and perceptions.

August 24, 2016

The effect of staff nurses' shift length and fatigue on patient safety and nurses' health: from the National Association of Neonatal Nurses.

October 21, 2015

Resident Duty Hours Across Borders: An International Perspective.

January 21, 2015

Understanding the effect of resident duty hour reform: a qualitative study.

August 13, 2014

Patient safety in the era of the 80-hour workweek.

May 14, 2014

Inpatient safety outcomes following the 2011 residency work-hour reform.

April 2, 2014

Residency Training—A Decade of Duty-Hour Regulations.

December 18, 2013

Identifying potential predictors of a safe attending physician workload: a survey of hospitalists.

October 30, 2013

Approval and perceived impact of duty hour regulations: survey of pediatric program directors.

October 23, 2013

Safety during night shifts: a cross-sectional survey of junior doctors' preparation and practice.

October 23, 2013

Sleep deprivation: a call for institutional rules.

September 25, 2013

Residency schedule, burnout and patient care among first-year residents.

September 4, 2013

Teaching hospital five-year mortality trends in the wake of duty hour reforms.

August 7, 2013

Some doctors questioning whether shorter shifts for interns are endangering patients.

July 24, 2013

Duty-hours monitoring revisited: self-report may not be adequate.

June 19, 2013

Duty-hour limits and patient care and resident outcomes: can high-quality studies offer insight into complex relationships?

May 22, 2013

The impossible workload for doctors in training.

May 1, 2013

Duty hour reform in a shifting medical landscape.

April 24, 2013

Change in intern calls at night after a work hour restriction process change.

April 10, 2013

Effects of the 2011 duty hour reforms on interns and their patients: a prospective longitudinal cohort study.

April 3, 2013

Effect of the 2011 vs 2003 duty hour regulation-compliant models on sleep duration, trainee education, and continuity of patient care among internal medicine house staff: a randomized trial.

April 3, 2013

See More About The Topic

Hospitals

Health Care Providers

Health Care Executives and Administrators

General Internal Medicine

Hospital Medicine

Attending physician work hours: ethical considerations and the last doctor standing.

Fatigue, Sleep Deprivation, and Patient Safety

Connect With Us

Sign up for Email Updates

Agency for Healthcare Research and Quality

Attending physician work hours: ethical considerations and the last doctor standing.

Fatigue, Sleep Deprivation, and Patient Safety

Connect With Us

Sign up for Email Updates

Agency for Healthcare Research and Quality

PSNet Log in

Submit Your Innovations

Continue as a Guest

Continue Logged In

Submit Your Innovations

Continue as a Guest

Continue logged in

New Users to the PSNet site