People get sick 24 hours a day – in the middle of the night, on weekends, and (gasp) even on holidays. Hospitals are open 24/7/365, but are typically staffed with perhaps only a third as many doctors on weekends as they would have on any weekday. Doctors may be “on-call,” supposedly waiting at home with phone in hand, but it can still take 30 minutes or more for a specialist to get to the hospital and be ready to see a critically ill or injured patient.
Nurses are usually staffed at close to weekday levels, but physiotherapists, dieticians and other health professionals who aren’t MDs, but are just as critical to the health, comfort, and sometimes even the survival of patients get weekends and nights off. It’s commonly cited as a trade-off for the fact they don’t make as much as doctors.
Go into any hospital at 2:00 a.m. and it will seem absolutely deserted. It’s true that most patients already in the hospital will be sleeping, requiring, for the most part, less intensive care; but what happens to the patient who arrives at 1:00 a.m. after a heart attack, and seems to be stabilized, so the doctor goes home, deciding not to perform angioplasty in the middle of the night, even though it’s critical to open clogged arteries within 90 minutes of a heart attack. If the patient suffers another attack an hour later, death is much more likely than if they had received angioplasty.
The Weekend Effect
Since 2001, when a study was published in the New England Journal of Medicine, the increased risk of death on nights and weekends has become known as the “weekend effect.” For most health conditions, the relative increase in deaths is small but statistically meaningful. If it’s your loved one in the hospital who is at increased risk, that statistically small number is even more meaningful.