Are long physician working hours harmful to patient safety?

Background: Pediatricians of Japanese hospitals including not only residents but also attending physicians work long hours, and 8% work for > 79 h per week. Most of them work consecutively for >= 32 h when they are on call. The aim of the present study was to evaluate the effect of long work hours on patient safety. Methods: The electronic databases MEDLINE and EMBASE to searched identify the English- and Japanese-language literature for studies on work hours, medical errors, patient safety, and malpractice for years 1966 - 2005. Studies that analyzed the relationship between physician work hours and outcomes directly related to patient safety were selected. Results: Seven studies met the criteria. Four studies suggest that reduction of work hours has a favorable effect on patient safety indicators. In the other three studies no significant changes of the indicators were observed, but no report found that shorter work hours were harmful to patient safety. Conclusion: Decrease of physician work hours is not harmful but favorable to patient safety.