Doctors have less empathy to manage pain on night shifts - study

A new study showed that doctors who were tired after night shifts prescribed less painkillers because they had less empathy for pain.

Prescription pain pills are dumped out on a table. (photo credit: U.S. AIR FORCE PHOTO ILLUSTRATION/TECH. SGT. MARK R. W. ORDERS-WOEMPNER)
Prescription pain pills are dumped out on a table.
(photo credit: U.S. AIR FORCE PHOTO ILLUSTRATION/TECH. SGT. MARK R. W. ORDERS-WOEMPNER)

Doctors have less empathy for pain during their night shifts than during day shifts and therefore prescribe painkillers less during the night, according to a study published on Monday.

The study, which was published in the peer-reviewed Proceedings of the National Academy of Sciences (PNAS), was led by Prof. Shoham Choshen-Hillel, Dr. Anat Perry and Dr. Alex Gileles-Hillel from the Hebrew University of Jerusalem.

As part of the study, 67 doctors were given a number of empathy assessment tasks in the morning. Some of them were starting their day, and some had just ended a night shift. The doctors who were coming off a night shift showed less empathy for pain.

In addition, the researchers analyzed 13,482 discharge letters from Israel and the United States in which patients had arrived at the emergency room with complaints of pain. The data confirmed that doctors on night shifts were less likely to prescribe painkillers to the patients.

“They’re tired and therefore they’re less empathic to patients’ pain."

Prof. Shoham Choshen-Hillel
 (L to R): Anat Perry, Shoham Choshen-Hillel, Alex Gileles-Hillel.  (credit: HEBREW UNIVERSITY) (L to R): Anat Perry, Shoham Choshen-Hillel, Alex Gileles-Hillel. (credit: HEBREW UNIVERSITY)

“Our takeaway is that night shift work is an important and previously unrecognized source of bias in pain management, likely stemming from impaired perception of pain," said Perry. "The researchers explain that even medical experts, who strive to provide the best care for their patients, are susceptible to the effects of a night shift.” 

How to improve the situation

The study suggested that two ways to improve the issue were to improve doctors' working schedules and to provide stricter guidelines for how to manage pain in hospitals.

“Our findings may have implications for other workplaces that involve shift work and empathic decision-making, including crisis centers, first responders and the military," said Gileles-Hillel. "In fact, these results should probably matter to all people who are sleep-deprived.”