Thinking Citizen Blog — Medical Resident Work Hours: to Regulate or Not to Regulate
Thinking Citizen Blog — Thursday is Health, Health Care, Health Insurance and Global Health Policy Day
Today’s Topic: Medical Resident Work Hours: to Regulate or Not to Regulate
Are medical residents in the US “abused” by being forced to work much, much longer hours than their European counter-parts? What is the actual gap in weekly hours? Who should decide what is best for residents and patients? How should the decision be made? I have heard anecdotally that variation in hours in Europe are considerable — with a Dutch resident recently telling me that while she works 10 hours per day for four days her Swedish colleagues are only expected to work six hours per day. True? Experts — please chime in. Correct, elaborate, elucidate.
EUROPEAN REGULATIONS: HOURS PER DAY AND PER WEEK, DAYS OFF, BREAKS
1. 48 hours per week
2. 11 continuous hours per day
3. One day off each week or two per fortnight
NB: 20 minutes of continuous rest every six hours.
US REGULATIONS: set by a private trade association — the ACGME (Accreditation Council of Graduate Medical Education)
1. 80 hour work limit
2. 24 hour limit on continuous duty
3. A 10 hour rest period between duty periods
THE LIBBY ZION CASE THAT TRIGGERED REGULATIONS IN NEW YORK STATE
1. In 1989, the New York Department of Health limited resident weekly hours to 80 after the death of an 18-year old patient, Libby Zion, due to “overworked” resident physicians.
2. “Although regulatory and civil proceedings found conflicting evidence about Zion’s death, today her death is widely believed to have been caused by serotonin syndrome from the drug interaction between the phenelzine she was taking prior to her hospital visit, and the pethidine administered by a resident physician.”
3. “The lawsuits and regulatory investigations following her death, and their implications for working conditions and supervision of interns and residents, were highly publicized in both lay media and medical journals.”
Resident duty hours around the globe: where are we now?
[Perception of mistreatment during medical residency training] — PubMed
Opinion: Keep Limits Intact On Medical Residents’ Work Hours
Study says limits on residency work hours didn’t affect doctor performance
For the last three years of posts organized by theme:
PDF with headlines — Google Drive
YOUR TURN
Please share the most interesting thing you learned in the last week related to health, health care or health care policy — the ethics, economics, politics, history…. Or the coolest, most important thing you learned in your life related to health are or health care policy that the rest of us may have missed. Or just some random health-related fact that blew you away.
This is your chance to make some one’s day. Or to cement in your mind something really important you might otherwise forget. Or to think more deeply than you otherwise would about something that matters.
