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Shorter Hours for Residents May Come with Financial Consequences

Jeff Elliott, for HealthLeaders Media, November 11, 2010

ACGME said in a statement that the requirements for doctors-in-training are a "comprehensive package of interrelated standards designed to better match residents' levels of experience and emerging competencies, advancing both graduate medical education and safe quality patient care in the nation's teaching hospitals."

"Implementing [the rules] will require small changes in some programs and large changes in others, all with the goals of ensuring patient safety, that the next generations of physicians are well-trained to serve the public and that residents receive their training in a humanistic learning environment," said ACGME CEO Dr. Thomas Nasca.

Critics argue that while the patient-safety intent of the duty rules is good, many institutions already burdened with financial challenges will require significant, often costly staffing changes. "This could be particularly difficult right now for organizations with the economy as it is," Duran-Nelson said.

The University of Minnesota hospital plans to restructure its call systems at two of its three sites and hire several hospitalists as it creates a nighttime junior hospitalist rotation to help address certain ACGME requirements.

Duran-Nelson also believes that the rules will force residency programs to become more creative with their education efforts. For instance, she says students will probably gain more experience in labs and simulated environments rather than the clinical setting, which does have its advantages.

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