Resident physicians may once again be working shifts of over 24 hours, putting patients’ lives at risk. The Accreditation Council for Graduate Medical Education (ACGME) proposed last week to raise the limit on first-year residents’ shifts, allowing the new doctors to work up to 28 hours without sleep. The proposal would remove the five-year-old 16-hour limit on first-year residents’ shifts.
According to ACGME’s proposal, the change in hours was suggested in the interest of “a commitment to avoiding disruption of team-based care and [facilitating] seamless continuity of care.” The change would align first-year physicians and do away with the adoption in 2011 of the 16-hour shift limit for those first-year physicians, commonly called “interns.” The 2011 reduction to the 16-hour limit on intern shifts came as a result of a study conducted by the Institute of Medicine on patient safety and work-hour rules.
According to a report in the Washington Post, if approved in February the new limit would go into effect in July. “It is the latest development in a decades-old effort by the medical profession to balance the education of doctors with patient safety,” the Post said.
A report by watchdog group Public Citizen calls the proposed change “a dangerous step backward” and claims that the lengthened hours “would expose residents, their patients and the general public to the risk of serious injury and death.” According to Dr. Michael Carome, Director of Public Citizen’s Health Research Group, “Study after study shows that sleep-deprived resident physicians are a danger to themselves, their patients and the public.” Carome continued, “It’s disheartening to see the ACGME cave to pressure from organized medicine and let their misguided wishes trump public health.”
Public Citizen points out that, in addition to flying in the face of the data, the proposed change ignores the will of the American people. A public opinion poll commissioned by Public Citizen found that “more than four out of five Americans oppose any resident physician working more than 16 hours in a row without sleep.”
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