Sleeping at Work

Medicine’s sleep deficit

A few days ago, after a long night of working on a project, I woke up after far too little sleep with a headache and a deep desire to dive back between the covers.  As I crawled slowly into the shower, I realized that this was a feeling that I should get used to, that a large chunk of medicine — clerkship, internship, residency — was built on sleep deprivation.  But maybe that’s contributing to the core problem with healthcare today.

At my last job, I was expected to improve efficiency for a large team and think creatively about challenges that we faced.  When I woke up after working too late into the night, I would roll back over and continue sleeping until I had enough sleep time to be refreshed and invigorated (of course, first ensuring that my phone was set to ring loudly if anyone needed me).  My work day was flexible, and it was generally understood that a full night’s sleep would lead to even more than that in gains in efficiency and clarity of thought.  Likewise, a slow start to the day and time in the shower added value because they maximized my quiet “thinking time”, helping me to identify the best solution to complex challenges, a strategy that has shown to be effective with leaders in innovation like 3M.  Recent research from Stanford supports this idea that the path to innovation starts with a great night’s sleep.

Recently, a representative from a large management consulting firm spoke with our medical school about his experiences in the healthcare industry.  Some stories were interesting, but many of the cases seemed to be frighteningly simple — a nurse who had stopped answering her phone for hours every day, serving as a bottleneck in traffic; a diagnostic lab that needed to be set up closer to the ER or OR; a doctor who had to be coaxed to accept healthcare management best-practice like checklists, departmental team meetings, or chart reviews.

This is scary but also understandable given the sleep deprivation that is so rampant in the industry.  Without a good night sleep, people have impaired problem-solving capabilities and they are much more focused on just getting through the day than on improving or innovating in their environment.  Maybe with an emphasis on shorter working hours, healthcare management would find more energy to be creative.  And maybe this creativity would disrupt and improve an entire industry.  Probably not.  But if you need to hire a management consultant to tell you to answer your phone, it might be worth checking out other ideas as well.