Decision Fatigue

This is from an interesting article by Nicholas Bakalar in the NY times:

The phenomenon of “decision fatigue” has been found in judges, who are more likely to deny parole at the end of the day than at the beginning. Now researchers have found a parallel effect in physicians: As the day wears on, doctors become increasingly more likely to prescribe antibiotics even when they are not indicated.

For the study, published in JAMA Internal Medicine, scientists analyzed diagnoses of acute respiratory infections in 21,867 cases over 18 months in primary care practices in and near Boston.

In two-thirds of the cases, antibiotics were prescribed even though they were not indicated. But whether they were indicated or not, the number of prescriptions increased with time. Over all, compared to the first hour, the probability of a prescription for antibiotics increased by 1 percent in the second hour, 14 percent in the third hour and 26 percent in the fourth.

“The radical notion here is that doctors are people too,” said the lead author, Dr. Jeffrey A. Linder, an associate physician at Brigham and Women’s Hospital in Boston, “and we may be fatigued and make worse decisions toward the end of our clinic sessions.”

But, he added, the patient can help. “If you want the best care, you should say that you are there to be evaluated, and only want an antibiotic if it’s really needed.”

Now decision fatigue is something I'm sure is not restricted to judges or doctors. Like said by the doctor here, doctors are people too. It's just that the impact from judges and doctors is more critical and clearly measurable. It's good for us to remember this, not only when we need to go see doctors end of the day, but also when we take decisions ourselves at the end of a long day, right?