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The effects of fatigue on physician performance - an underestimated cause of physician impairment and increased patient risk


Evidence is reviewed demonstrating the high level of drug and alcohol abuse and marital disharmony among physicians and the particularly high rate among anaesthetists. The relationship between these factors and the effects of fatigue is explored. The current evidence for reduction in physician performance and vigilance resulting from fatigue and sleep loss is reviewed. Supplementary indirect evidence is surveyed which suggests that increased experience may not compensate adequately for this reduced performance. Since hours of work can be controlled, it is essential that anaesthetists, their professional organizations and regulatory agencies ensure that pressure for efficiency does not result in fatigue and the consequent compromise of both patient and physician health and safety.


On présente de ľévidence du niveau élevé ďabus de médicaments et ďacool, de problèmes familiaux parmi les médecins, et tout particulièrement parmi les anesthésistes. On examine la relation entre ces facteurs et les effets de la fatigue. Ľévidence actuelle de la perte de performance et de vigilance du médecin, causée par la fatigue et la perte de sommeil est révisée. On examine ďautre évidence indirete qui laisse entendre que ľexpérience de ľanesthésiste ne compense peut être pas pour cette perte de performance. Puisqu’il est possible de contrôler des heures de travail, il est essentiel que les anesthésistes, et leurs organisations professionnelles et régulatrices s’assurent que la production n’ entraîne pas une fatigue qui compromettrait la santé et la sécurité du patient et du médecin.


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Correspondence to John B. R. Parker.

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Parker, J.B.R. The effects of fatigue on physician performance - an underestimated cause of physician impairment and increased patient risk. Can J Anaesth 34, 489–495 (1987).

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Key words

  • PSYCHOLOGIC RESPONSES: sleep deprivation
  • fatigue
  • ANAESTHETISTS: performance
  • fatigue