ELI5: How do doctors perform with little to no sleep?

Submitted by MemeBoi0508 t3_yhozv4 in explainlikeimfive

Father's a doctor, my mom and I used to sleep with him during his duty days. Was constantly getting knocks, doesn't matter what time of the day it was or if he was sleeping.

Shouldn't proper sleep be important for doctors? He's a surgeon and the room we were in was very close to the E.R, I'm assuming he does work there (still not sure to this day, was a little kid back then).

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ShalmaneserIII t1_iuf52wo wrote

Practice!

Also, if you want to give doctors uninterrupted sleep, you need more doctors. They're more expensive than people want to pay for.

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TheLuteceSibling t1_iuf2sfl wrote

Doctors have to be available in the middle of the night because emergencies also happen at night. They take turns being “on call” like your dad was, and they sleep normally on their days off and on normal work days.

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waylandsmith t1_iuh1065 wrote

You may not want to know the answer to this question: Poorly.

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GratefulG8r t1_iuhsra9 wrote

Yes. And yet it is tolerated in the medical profession for cultural reasons. The medical profession is a culture and although medicine is based in science, just like any culture there are customs, habits, and practices that are not necessarily grounded in scientific fact but exist for other reasons such as profit, tradition, formality, or even ego/machismo. Medical residents are used as almost indentured servants for hospitals under the auspices of "learning a lot in a short period of time" and the profession accepts that residents will work ungodly hours on insufficient sleep because, well, that's just how its always been done (cultural reason) and it is also treated as a rite of passage into an elite profession... I hesitate to say hazing but that term also comes to mind.

There has been pushback and efforts to reform this culture of overwork in recent years due to the recognition that less sleep = more mistakes = worse patient care, but by and large residents, and even many career hospitalists, are still used and abused as if the research on sleep deficit isn't clear and established. Hospitals have a profit motive to keep fewer doctors on staff, and the medical profession also strictly regulates the number of medical schools and their graduation output so as to limit the amount of practitioners to a certain amount... this is done to maintain scarcity (and therefore high salaries).

Ironically, limiting the number of practicing doctors to limit competition has opened doctors up to competition from nurse practitioners and other "mid level" providers who are succesfully lobbying states to allow them to independently practice with nearly the same responsibilities as doctors. The lobbying efforts are succesful because the lobbyists can point to "shortages" of doctors and also argue that nurse practitioners can do essentially the same job for cheaper --thus increasing access to health care and lowering the cost of care. (The fact is that nurse practitioners are not as educated or as competent as doctors, and the rapid expansion of NP schools has resulted in many new NPs with worse academic backgrounds than in previous decades, but their lobbying efforts are nevertheless effective)

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waylandsmith t1_iuigr1w wrote

I worked for 8 years at a software company working with reformers in the medical system trying to fix how the active learner and "resident" system works. It was pretty disturbing to learn how things work at a typical learning hospital. Especially frightening was discovering that "evidence based medicine" is (was?) still a relatively fringe idea that there was large resistance to. The system sucks. I live in Canada where the learning system is a bit better, but we have a significant brain drain problem where Canadians attend a relatively affordable medical program here and then move to the states to earn the big bucks in the private medical system.

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jensjoy t1_iuf6nw5 wrote

We've evolved to function under constant stress with little sleep for survival reasons.
Imagine our ancestor resting after escaping a predator. If bad luck happened and another predator spotted them, those who could get up and mobilise enough energy for another escape survived.
But that only works for a while.
I hope your dad got enough rest between those shifts or it is likely to have taken a toll on him/his health.

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Serraptr t1_iuiv7yg wrote

i finished my residency in march and have since gotten a corporate job that is 9-5, but I still have a lot of issues sleeping. the truth is that medical school and residency is pretty demanding and sleep becomes second on the priority list

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