AMA Wire

Wednesday, April 3, 2013

For Residents

New duty hour rules may cause more errors: study

A new study raises questions about whether recently implemented rules reducing the number of hours residents can work have improved patient safety as intended.

The study, published in JAMA Internal Medicine, found that 19.9 percent of interns reported committing an error that harmed a patient in 2010. When the new rules took effect the following year, that number increased to 23.3 percent. Meanwhile, hours of sleep and risk for symptoms of depression remained steady. The study looked at more than 2,300 doctors in their first year of residency at more than a dozen hospital systems across the country.

Srijan Sen, MD, the study's lead author, was surprised by the results. "That's a 15 to 20 percent increase in errors—a pretty dramatic uptick, especially when you consider that part of the reason these work-hour rules were put into place was to reduce errors," he said.

Those in the field suggest that work compression may be to blame. When the Accreditation Council for Graduate Medical Education implemented new duty hour rules in 2011, the length of time residents were permitted to work consecutively was cut back from 24 hours to 16. But these reductions were not accompanied by an increase in funding, leaving current interns with less time to complete the same amount of work.

Dr. Sen cautions, however, that the current data are not sufficient to support an indictment against the new duty hour rules. He believes further study is needed to assess what's happening and how to better support new trainees.

The AMA continues to advance the development of responsible policy on resident duty hours. Visit the AMA's Resident and Fellow Section advocacy and policy page to read the AMA's reports on resident duty hours.

Sequestration to impact medical research funding

The National Institutes of Health (NIH) is slated to lose $1.6 billion of its $30-billion budget through the federal cuts known as the sequestration, the L.A. Times reports.

The cuts have scientists worried that medical research into diseases like cancer, Alzheimer's and influenza may suffer as a result.

The NIH is the world's largest supporter of biomedical research, and supporters say NIH-funded discoveries contribute economically to the nation's booming biomedical industry. If grant funding becomes harder to obtain, some worry that young scientists—including resident and fellow physicians—will be disinclined to go into research, or may leave the United States for better funding opportunities abroad.

The AMA and nearly 130 other medical associations sent a letter to Congress in December, cautioning lawmakers about the consequences for programs such as this if the budget sequester were to take effect and urging Congress to come to a well-planned solution to reduce the federal deficit.

Finishing residents: Exclusive disability plan available

A unique individual disability insurance plan, introduced by AMA Insurance Agency's Physicians Financial Partners program, is being offered again this year to eligible finishing residents across the country.

The Essentials Disability Income Insurance Plan is available exclusively to eligible finishing residents and is issued by Metropolitan Life Insurance Company (MetLife). The program utilizes a simplified application process with just a few basic questions and no intrusive or time-consuming medical exams. At the same time, residents are offered lower rates than those of MetLife's typical fully underwritten policies.

Through this plan, eligible residents have a special one-time opportunity to apply for high quality individual disability insurance as they complete their residency training.

Open enrollment to apply for this important coverage runs April 1 through June 30.

Visit the Essentials website or call (866) 717-8029 to learn more about this plan.