More rest for the weary residents

The Institute of Medicine wants to further restrict the amount of work medical residents do.

The 80 hour cap on work-hours aren’t routinely enforced, which puts patients at risk for medical errors by sleepy doctors.

The committee smartly addressed the problems with patient hand-offs, a necessary evil when more doctors are involved with a patient’s care. Another recommendation is a mandatory five-hour nap after working more than 16 hours.

The biggest problem with instituting these suggestions is cost. Hospitals are already fiscally squeezed, and will have to hire additional staff to compensate for the reduced amount of work that residents are mandated to do. This includes hiring more hospitalists to staff “non-teaching” services, mid-levels to round on routine patients, and ancillary staff to reduce the scut burden on residents.

Whether hospitals are willing to comply is still in question.

Robert Centor is concerned about the impact these further restrictions will have on teaching, saying already “we have residents who cannot attend noon conference because their ‘shift’ is over. How does that help the resident?”

Another concern is that the real world post-residency has no such work restrictions. How will these newly graduated doctors handle a world where they may be forced to work more than 16 hours straight, or 80 hours a week?

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