A new study has found that tired doctors are less likely to prescribe painkillers.
Tired doctors have less empathy for patients in pain and are less likely to prescribe painkillers, according to a new study.
Researchers asked a group of physicians about 2 theoretical clinical scenarios where patients in pain. One was a woman with a headache and another, a man with a backache. The physicians were asked about their perception of how much pain each patient was in and how likely they were to prescribe painkillers. Overall, the doctors who had just started their working days were more likely to show empathy for the patients than those who had just finished a 26 hour shift.
The work, published in the journal Proceedings of the National Academy of Sciences was conducted by researchers from the University of Missouri School of Medicine and a team of researchers in Israel
“This study demonstrated that night shift work is an important and previously unrecognized source of bias in pain management, likely stemming from impaired perception of pain,” said said author David Gozal, MD, the Marie M. and Harry L. Smith Endowed Chair of Child Health at the University of Missouri School of Medicine.
The researchers also looked at 13,000 electronic medical record notes from patients who had arrived reporting symptoms of pain in hospitals in both the U.S. and Israel. When the patients were seen by physicians on a night shift, they were 11% and 9% less likely to be prescribed painkillers in Israel, and the U.S. respectively.
“Pain management is a major challenge, and a doctor’s perception of a patient’s subjective pain is susceptible to bias,” said Gozal.
Although the research describing less propensity to prescribe painkillers at night time is a new finding, bias in the prescription of pain relief medication has been described before. Notably, one study found that physicians were about half as likely to prescribe opioid painkillers to Black patients in the ER, compared to white patients.
With the ongoing Covid-19 pandemic, record numbers of physicians and healthcare staff are reporting burnout and fatigue, which could be contributing to bias in prescribing painkillers to patients in pain.
“These results highlight the need to address this bias by developing and implementing more structured pain management guidelines and by educating physicians about this bias,” said Gozal about his study, adding that it is important for hospitals to recognize that physician work schedules can contribute to empathy or decision fatigue.
