The studies that justify it are absolutely bonkers too. One study compares the ACGME limits (max 24 hour shifts) against a "flexible" system with 28 hour ones.

The studies that justify it are absolutely bonkers too. One study compares the ACGME limits (max 24 hour shifts) against a "flexible" system with 28 hour ones. Unsurprisingly, there's no effect--since both groups are totally zonked at the end. Meanwhile, data from lab experiments and virtually every other field (trucking, aviation, etc) shows that performance craters well before that. The rationale for long shifts (other than money) is "handoff": when a new doctor takes over, details about the patient's condition and treatment plan get lost in the shuffle. In some cases, they might not ever have been recorded (e.g., a subliminal impression of a patient's color or breathing). Many people are weirdly nihilistic about improving this, but it seems like it almost has to be the lower-hanging fruit since solving it doesn't require butting up against fundamental limits of human physiology.