Shorter Hours for Residents May Come with Financial Consequences

Reduced residency duty-hour rules could increase hospitals' financial burdens and hinder education efforts, according to a report published in Minnesota Medicine.

Authors Dr. Allison Duran-Nelson, Dr. Joan Van Camp, and Dr. Louis Ling of the University of Minnesota suggest that new rules proposed by the Accreditation Council for Graduate Medical Education (ACGME) to limit first year residents' work-day hours to 16 could have the unintended consequence of causing "more stress for those physicians who want to be there for their patients." Longer shifts are currently the norm.

"It's primarily the residents that have a disagreement with the rules," said Duran-Nelson, director of the University's internal medicine residency program, in an interview. "As soon as we told interns they would no longer be allowed to do overnight calls and work more than 16 consecutive hours, they expressed some concerns about how that would affect their education."

The new, stricter rules scheduled to go into effect in July 2011 will replace ones that were instituted in 2003. They were devised by a 16-member ACGME task force made up of medical education, patient safety, and clinical care specialists.

Duran-Nelson noted that workday limits are the primary hangup with the new wide-ranging rules, citing a national survey indicating that 85 percent of residency program directors disagreed with this regulation, with nearly all saying they were in favor of other rules guiding time off and workloads.