Kate Hagan July 14, 2012
More than half of public hospital doctors in Australia are working excessive hours that could be jeopardising patient safety, an audit has revealed.
An Australian Medical Association survey of almost 1500 doctors found 53 per cent were working hours that put them at high or significant risk of fatigue, including one doctor who worked a 43-hour shift and another who worked a 120-hour week.
AMA vice-president Geoffrey Dobb said the results were concerning in light of evidence that a person's performance after being awake for 17 hours was impaired to the same extent as if they had a blood alcohol concentration greater than 0.05 per cent.
''If this impairment was actually the result of alcohol consumption, prevailing hospital policies would prevent these doctors from working,'' he said.
''We need urgent action from governments and administrators to create and maintain safer working environments for doctors.''
AMA Victoria president Stephen Parnis said demand on the hospital system was increasing each year and new national targets for doctors to treat more emergency patients within four hours would only add to the pressures.
Victorian Health Minister David Davis has failed to conduct his own audit of doctors, as promised during the 2010 election campaign, which Dr Parnis said could inform structural changes to reduce unsafe hours including overlapping shifts that enabled doctors to conduct thorough handovers.
Asked about the promise yesterday, a spokeswoman for Mr Davis said he was ''constantly in discussions with the AMA on a range of important issues, including the working hours of our public hospital doctors''.
Dr Parnis said he had not spoken to Mr Davis about the proposed audit, ''but we'd obviously welcome that and be very keen to advise and assist on what is an important issue''.
He said the AMA was likely to raise the topic of safe working hours with government as part of its negotiations on a new enterprise agreement.
The AMA's national audit conducted last August showed surgeons worked the most onerous hours, with 77 per cent of those surveyed at high or significant risk of fatigue.
The percentage of doctors found to be at high or significant risk of fatigue improved from 78 per cent in 2001, and 62 per cent in 2006. But the longest recorded shift and highest number of hours worked in the audit week both went up last year compared to 2006.
Professor Dobb said he did not believe patients' lives were being put at risk from doctors' excessive work hours due to safeguards in the system, including the fact that doctors worked as part of a team. But fifth-year obstetrics trainee Will Milford, who is chair of the AMA Council of Doctors in Training, said anecdotal evidence suggested the safety of doctors themselves was at risk.
''You get stories from junior doctors all the time who'll be on their way home from a very long shift and they'll be falling asleep at traffic lights,'' he said.
A study published in the New England Journal of Medicine found that the odds of an intern being involved in a car accident after working an extended shift was double that of interns working regular shifts. with AAP