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Working the night shift can be hard on the body, especially for those who work nights most of the time. Shift work disrupts the body’s circadian rhythm in ways that may increase the risk for cancer, cardiovascular disease, gastrointestinal disorders, metabolic conditions, and mental health issues.
This means a large number of physicians in the United States are at increased risk of health problems due to night shift work. Forty to 50% of hospitalists work some night shifts. About 10% of hospitalists are nocturnists, who work the night shift exclusively. Emergency medicine physicians work the most night shifts, with 95% of ED doctors working night shifts at some point in their careers.
Aside from major medical problems, night shift work can lead to other health issues that are not as serious, but problematic anyway. Research shows that those who work the night shift are three times more likely than day shift workers to have shift-related sleep disorders, such as:
• Daytime sleepiness, which can lead to errors in the workplace
• Insomnia, including difficulty falling asleep and staying asleep
• Irregular sleep patterns that make getting any meaningful sleep difficult
• Snoring/interrupted sleep, which leads to daytime drowsiness
Night shifts in the ER or hospital are typically 12-hour shifts that run from 7am to 7pm or from 7pm to 7am. While the 7-to-7 rotation is convenient for scheduling tests, making rounds, and coordinating staff, it isn’t necessarily good for the health of those working the night shift.
Specifically, the 7pm to 7am shift can alter sleep cycles. Disruptions to the circadian rhythm can trigger inflammation, which is involved in the development of many serious diseases.
To help their physician staff, some organizations are considering alternative emergency medicine scheduling and physician scheduling.
Switching to Casino Shifts May Help
In a study to be published in the September 2026 issue of The American Journal of Emergency Medicine, University of Missouri researchers show that making a small adjustment to the schedule can help the health and well-being of doctors working the night shift. Based on their findings, they suggest switching to “casino shifts.”
Casinos in North America typically have three shifts: Noon to 8pm, 8pm to 4am, and 4am to 12pm. In medicine, casino shifts usually run 12 hours, from 4 to 4.
The researchers enrolled 12 emergency department physicians into the study and followed them for 6 months. The investigators measured white blood cell (WBC) and platelet (PLT) counts, both of which are markers of inflammation, before and after the subjects switched to casino shifts. The markers decreased after the clinicians switched to the casino shift.
The study subjects also wore Fitbit devices that tracked their sleep patterns. The devices showed that, after switching to the earlier schedule, the physicians enjoyed more restorative sleep. They also awakened feeling more refreshed and well-rested.
ByteBloc MD scheduling software for Casino Shifts, Standard Shifts, and More
Using creative shift scheduling strategies requires powerful, flexible software. Introduced in 1989 for emergency medicine scheduling, ByteBloc Software now helps healthcare organizations in all 50 states, Canada, and other countries to provide flexible scheduling. For more information on flexible physician scheduling software, contact ByteBloc.
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