Student Docs Call for Relief
April 30, 2001 -- They're probably dangerous for you, and now student doctors say their shifts are hazardous for them, as well.
Consumer and health groups are blaming car crashes, depression, even reproductive problems on the grueling hours medical residents put in as part of their training.
The watchdog group Public Citizen today released a study and, with medical residency and health advocacy organizations, is petitioning the Occupational Safety and Health Administration for new regulations.
The students and residents cite studies showing their ability to function is impaired just as much as if they were legally drunk.
Medical residents studying to be doctors routinely clock 100 hours per week in hospitals, sometimes more, much of that time treating patients — often at the end of long and stress-filled shifts.
“Any system allowing its workers to be subjected to such direct threats to their well-being is seriously flawed,” says the petition. “For OSHA [the Occupational Safety and Health Administration] not to regulate resident work hours is to abdicate its responsibility to protect the health of those who care for the nation’s sick and dying.”
Some Defend the Hours
The study says the shifts are dangerous for the patients, as well. Previous complaints have blamed residents’ shifts for hospital mistakes.
"I know I made errors because I was sleep-deprived, and I was fortunate enough to have nurses or pharmacists check those orders or find those orders," says Risa Moriarity, a former surgical resident. "It did happen occasionally and I know it happened with lots of other residents."
Moriarity says she became so exhausted that she used to try to find ways to stay awake in the operating room.
The current method of training does have defenders, who say it’s like boot camp, pushing physicians to the limit both mentally and physically so they will be adequately prepared for any emergency situation.
The petition asks OSHA to limit residents to 80 hours of work per week, to no more than 24 hours at a stretch (doctors now routinely work 36-hour shifts), to limit on-call shifts, ensure 10 hours between shifts and otherwise ensure that doctors don’t suffer burnout.
"When I was a resident in the 1960s, we worked really long hours but the pace of the hospital care was much less than it is today," Jordan Cohen, president of the Association of American Medical Colleges, told ABCNEWS. "The association has been on record for over two decades calling for restriction on work hours for residents and working conditions for residents."
But he also says the association wants voluntary compliance, not federal regulations.
"It would require teaching hospitals to hire more personnel to meet their patient care obligations and there simply isn't the resources available to do that," he says.
OSHA says it has no jurisdiction over hours, only conditions, and cannot address the fatigue issue. The Labor Department said it is reviewing the petition and declined comment. So did the American Hospital Association.
One State Has Regulations, But …
New York, which is said to train more doctors than any other state, is the only state to regulate medical residents’ hours through legislation — to 80 hours per week. It limits shifts to no more than 24 consecutive hours.
The regulations were put into effect after a grand jury investigation into the death of Libby Zion, an 18-year-old college freshman — and daughter of prominent journalist Sidney Zion — who in 1984 died several hours after being admitted to a New York hospital, where she was treated by a sleep-deprived intern.
Critics, including New York City Public Advocate Mark Green, have said the regulations are not well-observed and need to be better enforced.
ABCNEWS’ Barbara Britt and John Martin in Washington, and Dorian Benkoil in New York contributed to this report.