Resident Workweek Rule Raises Concerns Among Teaching Hospitals About Cost, Care
Many of the country's teaching hospitals are concerned that the recent regulations limiting the number of hours medical residents can work will cost them "millions of dollars" and will force them to "think seriously about the best way to deliver care and educate residents," the New York Times reports. Already under financial pressure, teaching hospitals rely "heavily" on residents as an inexpensive source of labor, the Times reports. The new regulations, announced this week by the Accreditation Council for Graduate Medical Education, will limit the workweek for residents to 80 hours, will require that residents have at least 10 hours of rest between shifts and will restrict residents from working more than 24 hours at a time. The new rules, established to reduce the number of medical errors, will take effect in July 2003. The cost of complying with the new regulations will vary from hospital to hospital depending on what services the residents provide, according to the American Hospital Association. Some hospitals may choose to hire senior nurses or physician assistants to compensate for the residents' limited hours, and others may "curtail some of the areas where residents provide care," AMA Senior Vice President for strategic policy planning James Bentley said. Dr. Jon Cohen, chief medical officer for the North Shore-Long Island Jewish Health System, said hospitals could take a "huge financial hit," as hiring two or three physicians' assistants could cost a hospital four times as much as one resident. "No one knows where that money is going to come from," Cohen said, adding, "The big cultural change is the institutions have to recognize and treat residents as students." According to Mark Pauly, professor of health care at the University of Pennsylvania Wharton School, the financial costs of such changes will not be "catastrophic" (Abelson, New York Times, 6/14).
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