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Resident Duty Hour Reform and Mortality in Hospitalized Patients—Reply
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In Reply: We agree with Dr Neely that the effect of duty hours reform has been to force hospitals to hire substitutes for house staff (such as hospitalists), and that a comprehensive evaluation of the effects of duty hours reforms must therefore include effects on patients now cared for by these new clinicians, including the cost of their hire. Although these clinicians may be expensive, especially since they generally earn much more than house staff, it is also possible that their use could substantially decrease hospital costs and more than offset the added salary expenses. Unfortunately, we do not yet have rigorous studies based on clean experimental designs to assess this possibility. Nevertheless, it is possible that duty hour reform could have paradoxically resulted in cost savings.
We also support the comments of Dr Bell sharing the illuminating early history of the 80-hour work week and emphasizing the importance of . . . [Full Text of this Article]
David O. Meltzer, MD, PhD
dmeltzer@medicine.bsd.uchicago.edu
Vineet M. Arora, MD, MA
Department of Medicine
University of Chicago
Chicago, Illinois
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