Published online July 5, 2009
PEDIATRICS Vol. 124 No. 2 August 2009, pp. 758-762 (doi:10.1542/peds.2008-2953)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via CrossRef
Google Scholar
Right arrow Articles by Mercurio, M. R.
Right arrow Articles by Peterec, S. M.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Mercurio, M. R.
Right arrow Articles by Peterec, S. M.
Related Collections
Right arrow Office Practice
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

SPECIAL ARTICLE

Attending Physician Work Hours: Ethical Considerations and the Last Doctor Standing

Mark R. Mercurio, MD, MAa,b and Steven M. Peterec, MDa,c

a Department of Pediatrics
b Yale Pediatric Ethics Program, Yale University School of Medicine, New Haven, Connecticut
c Department of Neonatology, Lawrence & Memorial Hospital, New London, Connecticut

Based at least in part on concerns for patient safety and evidence that long shifts are associated with an increased risk of physician error, residents' and fellows' work hours have been strictly limited for the past several years. Little attention has been paid, however, to excessive attending physician shift duration, although there seems to be no reason to assume that this common practice poses any less risk to patients. Potential justifications for allowing attending physicians to work without hourly limits include physician autonomy, workforce shortages in certain communities or subspecialties, continuity of care, and financial considerations. None of these clearly justify the apparent increased risk to patients, with the exception in some settings of workforce shortage. In many hospital settings, the practice of allowing attending physicians to work with no limit on shift duration could pose an unnecessary risk to patients.

Key Words: ethics • medical errors • patient safety • pediatric workforce • physician practice patterns

Abbreviations: ACGME—Accreditation Council for Graduate Medical Education

Accepted Feb 2, 2009.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?