Hugh Pickens writes: "BusinessWeek reports that a commentary from the New England Journal of Medicine calls on doctors to disclose when they're deprived of sleep and not perform surgery unless a patient gives written consent after being informed of their surgeon's status. "We think that institutions have a responsibility to minimize the chances that patients are going to be cared for by sleep-deprived clinicians," writes Dr. Michael Nurok, an anesthesiologist and intensive care physician. Research suggests that sleep deprivation impairs a person's psychomotor skills — those that require coordination and precision — as much as alcohol consumption and increases the risk of complications in patients whose surgeons failed to get much shuteye. Unlike other practice areas, elective surgery is potentially amenable to rescheduling, although many competing interests influence that possibility, even when all parties stand to gain by avoiding errors and complications and improving outcomes. Some hospitals try to reduce the likelihood that physicians will lose sleep due to their work schedules. However, "a lot of institutions are not going to be able to take that leap immediately, so as an interim step, we believe that patients need to be informed," Nurok said. "Sleep deprivation affects clinical performance. It increases the risks of complications. And it is clear from survey data that patients would want to be informed if their physician was sleep-deprived and that most patients would request a different provider.""