Tuesday, July 1, 2003

A day late…

The other night I caught a snippet of something on CNN that made me curious. It sounded like some organization was going to place limits on the hours worked by medical residents. I can already hear the cries of "What? How can they do that? How will hospitals survive without cheap slave-like labor?"

Well, apparently the hints I picked up were true! The Accreditation Council for Graduate Medical Education has instituted new rules for all teaching hospitals (i.e.- hospitals with residents) which limit the number of hours and consecutive days residents can work. Anyone who has known a doctor while they were working through residency knows this is an extremely gruelling time. I can't tell you how many times I was asked questions regarding why my wife had to work such ridiculous hours during residency. But finally those days are over for doctors! Or are they?

The new requirements limit the hours worked in a week to 80, averaged over 4 weeks. Similarly, residents have to have one 24 period off every 7 days. Again, averaged over 4 weeks. Residents cannot work more than 24 hours on-call, with the exception that they can put in an additional 6 hours to transfer their patients to the care of the resident coming on duty. And finally, they cannot be on call more than every third night. Gee, sounds practically like a vacation! (sarcasm dripping from fingers as I type...)

Granted, this is an improvement, and I don't mean to suggest the changes are worthless. However, I still take my hat off to anyone who can make it through residency with their sanity intact and their stamina unbroken. Even the new standards will not make residency easy, so I don't want to hear any protests that this lowers the bar and lets just anyone get into medicine.

In addition, I will be interested to see how this impacts teaching hospitals and their ability to serve patients whose health care is largely funded by the government, now that their cheap-labor is less exploitable. As hospitals depend less on each individual resident, they will either have to take on more residents or they will have to bring in new attending physicians. Both options will raise the cost of treatment paid for by both private insurance companies and the government funded health care programs, and will serve to continue the increasing cost of health care in this country.

Eek, ack, we can't let health care costs increase! We have to legislate them down so every man, woman, child, and dog can get every procedure known to man, regardless of cost! (Keyboard shorts out due to sarcasm overload...)