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Shifting hospital risks at night

The Washington Post, June 7, 2011

A raft of studies has documented higher rates of death, complications and medical errors affecting patients treated at night or on weekends. “After normal working hours it’s mostly maintenance,” said Jessie Gruman, 56, director of the Washington-based Center for Advancing Health, a nonprofit health-policy group.“There’s a real sense of vulnerability you have at night when you know things are not happening at full speed. There’s less nursing care, less access to a doctor and more demands on doctors,” added Gruman, a veteran of more than 35 years of hospitalizations to treat cancer-related illnesses. To bridge the chasm between the day and night shifts, hospitals from Syracuse to Seattle are hiring a new breed of subspecialist called a “nocturnist” — an experienced doctor who works overnight taking care of patients outside the emergency room. The growing demand for these physicians, who typically work fewer hours and command higher