Time out for surgeons: when is the attending surgeon too tired?

Pediatric surgical subspecialty workforce shortages are here to stay without any expected solution for the short-term. Individual surgeons, hospital administrators, risk management and patient-safety teams need to recognize that patient safety must take precedence over clinical productivity and financial "bottom lines." Pushing attending surgeon work hours beyond the limits of exhaustion impairs patient safety. Just as resident surgeon work hours have been appropriately curtailed in the name of patient safety, so must attending surgeon work hours. This issue needs to be addressed by hospital patient safety committees, professional societies, and by state and national regulating authorities.