Medicine limits resident hours before legislation can

At its Annual Meeting, the AMA backs ACGME on an 80-hour week. While some hope this will preempt federal action, others voice concern over the impact on training programs.

By Myrle Croasdale, AMNews staff. July 8/15, 2002.

Physicians in training now have something in common with truck drivers and airplane pilots: restrictions on work hours.

The Accreditation Council for Graduate Medical Education set new rules on resident work hours, rules it plans to enforce as of July 1, 2003.

The American Medical Association is backing up the ACGME with a list of similar work-hour recommendations passed during its Annual Meeting in June.

Both groups stipulate resident physicians should work only 80 hours per week on average, going on-call no more than every third night.

The action comes in the shadow of legislation being considered by the federal government that threatens to set restrictions of its own.

David Leach, MD, executive director of the ACGME, said work hours are an issue because of a changing environment. "Hospital stays are shorter, patients are sicker and there's more pressure from falling reimbursement rates to do more with less staff. As a result residents are doing more in less time, with less help."

Peter Watson, MD, the resident physician on AMA's Board of Trustees, said while AMA policy doesn't have the power of enforcement, it was important to make its views known.

"We want to support [ACGME's] efforts, and we want to say 'We are watching you,' " Dr. Watson said.

The ACGME has not earned a reputation for strong oversight, but Dr. Leach said it had already gotten more rigorous in monitoring training programs for physicians. He said new enforcement measures would be used to track work-hour-rule compliance. [...]