Building Physician Work Hour Regulations From First Principles and Best Evidence
- Kevin G. Volpp, MD, PhD;
- Christopher P. Landrigan, MD, MPH
- Author Affiliations: Center for Health Equity Research and Promotion, Veterans Administration Hospital, Philadelphia, and Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia (Dr Volpp); and Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts (Dr Landrigan).
Since this article does not have an abstract, we have provided the first 150 words of the full text.
- KEYWORDS:
- EDUCATION, MEDICAL, GRADUATE
- EDUCATIONAL MEASUREMENT
- EVIDENCE-BASED MEDICINE
- FACULTY, MEDICAL
- HOSPITALS, TEACHING
- INTERNSHIP AND RESIDENCY
- PATIENT SAFETY
- PHYSICIANS
- REIMBURSEMENT MECHANISMS
- SLEEP DEPRIVATION
- TRAINING SUPPORT
- WORK SCHEDULE TOLERANCE
- WORKLOAD
In 2003, passage of the Accreditation Council for Graduate Medical Education (ACGME) work hour standards marked the first time that work hours for physicians in training were regulated throughout the United States. Five years later, the medical profession stands at a critical juncture. At the request of Congress, the Agency for Healthcare Research and Quality has sponsored an Institute of Medicine committee to review the evidence on the relationship between residents' work hours and patient safety and to develop recommendations for improvement.1
There is increasing evidence that resident sleep deprivation endangers patients and residents,2,3,4,5 but studies have not shown consistent benefit from implementation of the current ACGME standards. No changes in mortality were found in national studies of surgical patients.6,7,8 Some reductions in mortality were observed for medical patients at Veterans Administration hospitals8 and in a …
