Residents resting, part 2

Megan McArdle took issue with my last post on letting residents sleep.  Let me be perfectly clear:  sleep is good.  I think residents should sleep, and sleep well.   What Ms. McArdle overlooks is the fact that at present, residents are not allowed to work more than 80 hours per week (88 in some surgical specialties), nor are they allowed to work more than 30 hours at a stretch.  They don’t work the hallucinogenic 60 hour shifts or 120 hour workweeks that she describes.  The $1.6 billion dollar recommendations on the table won’t mean the difference between days without sleep and eight hours of slumber nightly.  In fact, the IOM recommendations keep the maximum hours per week right where they were, at eighty.  What the $1.6 billion dollars buy is one extra day off per month and a few extra hours off between certain shifts, changes anemic enough that I question whether they’ll create any significant difference in residents’ restedness.  So while I agree that sleep-deprived residents are a bad idea, I still say that $1.6 billion is questionable for what may be nothing more than a disruptive scheduling tweak.