Instead of 1 doctor covering a 24 hour shift, why not pair them and overlap?
12:00am - 6:00am: Doctor 1 and Doctor 4 are doing everything together.
6:00am - 12:00pm: Doctor 1 and Doctor 2 are doing everything together.
12:00pm - 6:00pm: Doctor 2 and Doctor 3 are doing everything together.
6:00pm - 12:00am: Doctor 3 and Doctor 4 are doing everything together.
This way, all 4 doctors only do 12 hour shifts, and the patient's state is maintained continuously through all 24 hours.
The answer is there’s already a doctor shortage, and the US simply does not have the capacity to effectively 2x the doctor-patient ratio.
Doctors are also unlikely to want a 50% pay cut in exchange for shorter hours. They aren’t directly exposed to the risk caused by fatigue since they will have malpractice insurance. Therefore the safer method of care would be simply too expensive, and doctors wouldn’t see an upside.
Part of the shortage is a result of artificially constrained supply as there aren’t enough med school seats to keep up with demand.
The doctor shortage is entirely caused by intentionally limiting how many doctors are admitted to med school every year
Doctors do not get along and that’s too many Drs. Each patient often has multiple speciality Drs visiting them and reviewing their case up to 3 or 4 sometimes already. Imagine being on consult and trying to figure out which guy on a team of 4 you should talk to about such and such.
Here's an anecdote that might help answer. When my wife was pregnant with our first doctor, she started hemorrhaging spontaneously ten weeks before her due date. We rushed to the ER.
1. Shortly after, a doctor A came in, asked some questions, looked at the chart, and told us she was having the baby tonight. Holy shit our life is about to get crazy and we're going to be parents 2+ months early! He leaves.
2. Several hours later doctor B comes in. We ask about delivery. "Oh, no. You're not going to have the baby now. But you will have to be on bed rest until the due date." Jesus, my wife is going to have to quit her job.
4. Even more hours later, now the next morning, doctor C arrives. "OK, you're free to go home. No bed rest needed. Just let us know if anything else happens."
My general experience with doctors is that you get as many unique opinions as there are doctors in the room. This is not an indictment of the profession. Human bodies are insanely complex, there is way more variation between them than most people realize, and doctors are operating under very very limited time and information.
Having overlapping doctors would likely cause even more patient confusion and increase the risk conflicting treatments. Also, it would obviously double the cost of care.
(My wife and baby were fine. Partial abruption. Very scary and my daughter was born five weeks early, but no other significant problems.)
Many industries have solved this issue already. Use a pilot/copilot model. First doctor drives, second one mostly observes and makes sure the first one doesn’t make mistakes.
Then you'd need to pay more doctors, and it would be much harder for the hospital to make a lot of money!
If engineers ran the world
Maybe doctors are divas and they tend to not communicate very well with others
That’s a lot of handovers.