Paging Dr. Drowsy

| December 12, 2008

If you pick up any newspaper and see the words “tired” and “driver,” you can be pretty certain that “truck” or “trucker” won’t be far behind. But recently, the sleepy drivers making headlines were not truckers, but doctors – specifically medical interns who slide behind the wheel after working 24- to 48-hour shifts. A study profiled in the New England Journal of Medicine found that doctors-in-training who work long hours are twice as likely to be involved in serious crashes after work as those who put in fewer hours.

This means four-wheelers – who are at fault in more than 70 percent of truck-related accidents – may finally be coming under the same type of scrutiny as truck drivers. The study’s researchers point out that doctors-in-training may face criminal prosecution for sleep-induced accidents.

A New Jersey law can already convict a person of reckless driving if he has gone without sleep for more than 24 hours. Reportedly, New York, Massachusetts and Michigan are considering similar legislation. Hospitals too, could be held liable for accidents involving overworked interns.

The research could also have a more direct impact on trucking, says C. Dennis Wylie, a consultant who analyzes human factors in motor vehicle operations. “The heightened risk associated with extended work shifts that has been identified [by the study] is convincing
scientific evidence of the need to improve the enforcement of the hours-of-service policy,” he says in a NEJM editorial.

But whether the problem is tired truckers or drowsy doctors, the need for tougher enforcement is only a symptom of a broken system. Would doctors-in-training work a 40-hour shift if it wasn’t an accepted part of becoming a physician? Would truckers drive out of hours if the pay for putting in a normal workweek was good and if carriers didn’t give away drivers’ time for free?

Probably not. But too often, no matter the industry, it takes the threat of a lawsuit or a hefty fine to change time-honored traditions. Like trucking companies, hospitals will have to make serious changes in their policies to address this issue. It will cost them money, primarily because they will have to hire additional staff to do the work that the overworked interns were doing. Does this sound familiar?

Because industries seem unable to change without pressure from outside, they often end up with policies that satisfy bureaucrats and safety advocates, but don’t solve the root problem. Let’s hope the changes coming in both these industries actually accomplish the goal of keeping tired drivers off the road.

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