What matters more in patient care? Giving doctors shorter hours of work or a good night’s sleep?

Focusing only on reducing hours of work may not have the desired effect of reducing symptom levels The long hours that doctors work, and the length and quality of their sleep, have long been viewed as influencing their health and the safety of care they give.1 In 2000 it was agreed by the European Parliament that the Work-time Directive, which had limited working hours in general, should also apply to doctors in training. This will mean no more than 58 hours per week by August 2004 and eventually a maximum of 48. In Europe this has more to do with the risks towards the doctor while in the US efforts to reduce long hours have come more from their threat to patient safety. But is this focus on hours the right one? There is certainly some evidence that a long working week will affect your health: a meta-analytical review of workers in general found small but significant positive correlations between overall health symptoms, physiological and psychological health symptoms, and hours of work.2 In Japan, where working hours are particularly long, this has been implicated in cardiovascular disorders and diabetes mellitus.3 Nevertheless, most studies show surprisingly little evidence for the relationship between hours of work and psychological well being: even …