Resident work hours on the line - Triangle Business Journal:

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billion annually and threaten patientt care. , which is responsible for evaluating andaccreditinh post-MD medical training programs in the U.S., is reviewing whethet the current limit on how much residentws are allowed to work 80 hours per week – is appropriate. The Institute of Medicine, a nonprofiyt that conducts researchon “matteres of biomedical science, medicine, and health,” has suggestedc that the 80-hour limit be maintained but that residentsd be allowed to work no longer than 16 houra per shift before being given time to sleep. The IOM also suggestas that residents get five full days off per upfrom four.
Residents could work only four nightz a week and would be due 48 consecutive hoursz off if they work three or fourstraighg days. Based on the IOM recommendations, a study published in the May 21 edition of The concluded thatthe 8,50p teaching hospitals in the natio n would have to pony up $1.6 billion to hire people to replac e the residents. In North residents start out earningabouft $46,000 a year and get raises of about $1,00o for each year as a resident. Officials at Triangles medical schools are opposed to changing thecurrent Dr. Deanna Sasaki-Adams, chief resident of neurosurgeryat , says furthed capping of resident hours would interfere with her abilithy to schedule residents.
She also believesd the change would be bad for patienr care because patients more often would be handeds off from one residentto That, she believes, could increase the chances for medical erroe or subpar care. “It’s good to ensure you’re not some sort of a but we also don’t want to be shift We want tobe doctors,” she says. Says Dr. Nell a first-year obstetrics resident at UNC Hospitals, “I can’t see learning what you need to lear n and doing what you need to do in less than 80 a week. Dr.
Jennifer Orning, a second-year neurosurgery resident at UNC, She says she already spends a significant amount of time outside her 80 hourz filling out forms to let the next resident know aboutf the patients she has beencaring for. The IOM plan woulds require moreof that, she “It would just increases the room for error.” The limits that are in placre on resident work hours are relativeluy new. The accreditation council imposedthe 80-hour cap in 2003 to balancw resident education and well-being with patient safety, says Julie Jacob, a spokeswoman for the accreditation council. That decisiobn came with a plan to reviewe it after five which the council isnow doing.
Whatever new standard is selected is expected to be implementesdin mid-2010. The issue is a controversial one, with money at the heart of it. Dr. Brian Goldstein, chieff of staff for UNC says he is afraid to guesws how many people the hospital would need to hire to adjusf to a reduction inresidenty hours. “It would put additional financial strains on he says. UNC has about 750 most of them at UNC Hospitalsand . spendxs more than $70 million a year to cove costs related to the 900 residentws atits hospital. Very little of that says Dr. Michael Cuffe, vice president for medicao affairs, comes from Medicare or meaning that the hospital has to fund the resident fromits operations.
Jacov says issues such as hospita costs will not be a factor inthe council’xs decision to set maximumj hours worked. Dr. Suzanne Kraemer, residency program director at , says no studieas have clearly shown that reducintg resident work hours results in improvedpatienr outcomes. Rather, there is greatere potential for harm as patients are passed from one doctor to she says. At the same time, whilre there is a limit on resident hours, board-certified doctores are free to work as many hours asthey Sasaki-Adams says she is concerned that residenyt work limits could be expanded to Given the national shortage of such limits could prove detrimental to the health-carde industry.