[billybob]

"due to the amount implicit knowledge that a doctor gathers during a >24h time period about his patients that can't be transferred in a handoff."

While this may be true, the process of the handoff could be vastly improved. My wife is a resident, and the quality of info she gets during a patient handoff varies drastically, from detailed notes in a computer, correlated to medical history, to scrawled notes on paper. Sometimes she has to start from square 1.

Maybe the reason handoffs are harmful is because they're done poorly. And maybe they're done poorly because the doctor who's handing off is freaking exhausted.