ArticleProceedings of the National Academy of Sciences of the United States of America2022
Physicians prescribe fewer analgesics during night shifts than day shifts.
Article in Proceedings of the National Academy of Sciences of the United States of America, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
12 citing papers in PubMed.
- Comparing the value of perceived human versus AI-generated empathy.Nature human behaviour · 2025Article
- No evidence for decision fatigue using large-scale field data from healthcare.Communications psychology · 2025Article
- QnAs with Shoham Choshen-Hillel and Alex Gileles-Hillel.Proceedings of the National Academy of Sciences of the United States of America · 2024Article
- Sleep, Well-Being, and Cognition in Medical Interns on a Float or Overnight Call Schedule.JAMA network open · 2024Observational
- Sex bias in pain management decisions.Proceedings of the National Academy of Sciences of the United States of America · 2024Article
- The new science of sleep: From cells to large-scale societies.PLoS biology · 2024Article
- Mediating and Suppressing Effects of Coping Styles Between Resilience and Empathy for Pain in Clinical Nurses: A Cross-Sectional Study.Journal of multidisciplinary healthcare · 2024Article
- Evaluating the relationship between pain empathy, knowledge and attitudes among nurses in North China: a cross-sectional study.BMC nursing · 2023Article
- Association of working hours and cumulative fatigue among Chinese primary health care professionals.Frontiers in public health · 2023Article
- Physicians prescribe fewer analgesics during night shifts than day shifts.Proceedings of the National Academy of Sciences of the United States of America · 2022Article
- Restless nights, cold hearts: Poor sleep causally blunts empathy.International journal of clinical and health psychology : IJCHPArticle
- Tired of war: Changes in the sleep of the Israeli civilian population in the wake of the Israel-Hamas war.International journal of clinical and health psychology : IJCHPArticle
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
Adequate pain management is one of the biggest challenges of the modern healthcare system. Physician perception of patient subjective pain, which is crucial to pain management, is susceptible to a host of potential biases. Here we explore the timing of physicians' work as a previously unrecognized source of systematic bias in pain management. We hypothesized that during night shifts, sleep deprivation, fatigue, and stress would reduce physicians' empathy for others' pain, leading to underprescription of analgesics for patient pain relief. In study 1, 67 resident physicians, either following a night shift or not, performed empathy for pain assessment tasks and simulated patient scenarios in laboratory conditions. As predicted, following a night shift, physicians showed reduced empathy for pain. In study 2, we explored this phenomenon in medical decisions in the field. We analyzed three emergency department datasets from Israel and the United States that included discharge notes of patients arriving with pain complaints during 2013 to 2020 (
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