Changes in medical resident work hour limits don’t address key problems

Medical and surgical residents could see the limit on their work hours increased from 16 to 28 under plans by the Accreditation Council for Graduate Medical Education (ACGME).


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The proposal could see current work hour limits, which were introduced after concerns over sleep deprivation and medical errors, reversed.

Work harder

Recent medical graduates are known as residents, and they undergo their clinical apprenticeships in hospitals. These residencies range from a minimum of three years to much longer for neurosurgeons, for example, and they give the residents on-the-job training and experience.

Until 1987, there were no limits to the number of hours worked by residents, but the death of freshman Libby Zion, which was written about by her lawyer and New York Times writer father, made people question why residents were working such long hours.

This led to the Bell Commission in 1987, which recommended that residents should work no more than 24 hours consecutively in a hospital and no more than 80 hours a week.

Further studies revealed that even these limits were not enough to prevent medical errors, leading the ACGME to impose an 80-hour limit on the number of hours in a week and limit the number of consecutive hours to 16 for a first-year resident and 24 hours for second and third-year residents.

According to the Harvard Gazette, shortened shifts did not compromise resident physicians’ training or lead to lower-quality doctors.

Healthcare regulation

As the above proposal to lengthen resident hours shows, healthcare regulations are open to continual change. It is not just medical staff who have to keep up-to-date, but also drug manufacturers, health insurers and healthcare providers.

Drug companies face tight controls on getting products to market and are forced to undergo the FDA 510k clearance process. This time-consuming process can be fast-tracked, however and many companies choose to consult an industry expert such as to get their products out quicker.

In the ever-changing healthcare industry, clinicians and other staff have to be adaptable, but the work-hour limit proposals will prove controversial, with many likely to argue they pose a threat to both residents and their patients.

Others, however, may question whether the existing caps have improved patient safety and reduced the amount of medical errors as they have led to more transition of care to other staff.

This article was written by Mike

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