Hospital Hazing

The New England Journal of Medicine has published a report showing—to quote the Los Angeles Times' summary—that "medical interns who drive home from the hospital at the end of a marathon shift…more than doubled their risk of getting into a car accident after being on call, a stint that meant working for 32 consecutive hours with only two or three hours of sleep, on average." The paper is

the latest in a series of studies by researchers at Harvard Medical School and Brigham and Women's Hospital in Boston that aim to quantify the dangers of requiring doctors to work long shifts with little rest. The researchers say that working for more than 24 hours causes interns to make serious medical errors and poses a public safety hazard.

That shouldn't be a surprise, but evidently it's a point that needs to be driven home. When Kevin Drum commented on the New England Journal article, he said that the system's defenders "sound like nothing so much as a bunch of 50s frat boys defending hazing after some freshman has been found dead in an arroyo somewhere."

Hazing is the right metaphor. The system serves the same purpose: It's a brutal initiation to a privileged club. Medical hazing is part of the set of barriers that limit entry to the profession; whatever other reasons there are for it, it's ultimately a byproduct of occupational licensing. Those long shifts don't just undermine public health. They drive away qualified men and women, reducing the supply of doctors and allowing those who survive the trial to charge more for their services.

[Via Alex Tabarrok, who notes that "more people die from medical mistakes each year than from highway accidents, breast cancer, or AIDS."]