Making Residency Work Hour Rules Work

5 Pages Posted: 21 Apr 2013  

I. Glenn Cohen

Harvard Law School

Charles A. Czeisler

Harvard University - Brigham and Women's Hospital

Christopher P. Landrigan

Harvard University - Brigham and Women's Hospital

Date Written: April 20, 2013

Abstract

In July 2011, the ACGME implemented new rules that limit interns to 16 hours of work in a row, but continue to allow 2nd-year and higher resident physicians to work for up to 28 consecutive hours. Whether the ACGME's 2011 work hour limits went too far or did not go far enough has been hotly debated. In this article, we do not seek to re-open the debate about whether these standards get matters exactly right. Instead, we wish to address the issue of effective enforcement. That is, now that new work hour limits have been established, and given that the ACGME has been unable to enforce work hour limits effectively on its own, what is the best way to make sure the new limits are followed in order to reduce harm to residents, patients, and others due to sleep-deprived residents? We focus on three possible national approaches to the problem, one rooted in funding, one rooted in disclosure, and one rooted in tort law. The definitive version of this article can be downloaded at Wiley-Blackwell website for this journal.

Keywords: Residency, Work Hours, Regulation, Sleep, Malpractice, Spending Clause, ACGME, Funding, Hospital

Suggested Citation

Cohen, I. Glenn and Czeisler, Charles A. and Landrigan, Christopher P., Making Residency Work Hour Rules Work (April 20, 2013). Journal of Law, Medicine and Ethics, Vol. 41, No. 1, 2013. Available at SSRN: https://ssrn.com/abstract=2254349

I. Glenn Cohen (Contact Author)

Harvard Law School ( email )

1525 Massachusetts Avenue
Griswold Hall 503
Cambridge, 02138
United States

Charles A. Czeisler

Harvard University - Brigham and Women's Hospital ( email )

Boston, MA 02115
United States

Christopher P. Landrigan

Harvard University - Brigham and Women's Hospital ( email )

Boston, MA 02115
United States

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