OSHA to consider stricter work hour rules for medical residents
The Obama administration will “review and consider” changes to the
rules governing the work hours of resident doctors — a group well known
for working extensive shifts for months and years on end.
The move comes in response to a petition launched last week by a coalition of consumer and labor advocates who say the
current hour limits aren’t strict enough to ensure the well-being of
either medical residents or the patients they treat.
current hour limits aren’t strict enough to ensure the well-being of
either medical residents or the patients they treat.
{mosads}The White House said Thursday that it tends to agree.
“We
are very concerned about medical residents working extremely long
hours, and we know of evidence linking sleep deprivation with an
increased risk of needle sticks, puncture wounds, lacerations, medical
errors and motor vehicle accidents,” David Michaels, head of the
Occupational Safety and Health Administration (OSHA), said in a
statement issued late Thursday.
are very concerned about medical residents working extremely long
hours, and we know of evidence linking sleep deprivation with an
increased risk of needle sticks, puncture wounds, lacerations, medical
errors and motor vehicle accidents,” David Michaels, head of the
Occupational Safety and Health Administration (OSHA), said in a
statement issued late Thursday.
“We will review and consider the petition on this subject.”
Additionally,
Michaels hinted that OSHA is eying work-hour reforms well outside the
realm of medicine. He noted, for instance, that investigators examining
the causes of a deadly 2005 Texas oil refinery explosion found that
“worker fatigue and long work hours” likely contributed to the
disaster, which killed 15 workers.
Michaels hinted that OSHA is eying work-hour reforms well outside the
realm of medicine. He noted, for instance, that investigators examining
the causes of a deadly 2005 Texas oil refinery explosion found that
“worker fatigue and long work hours” likely contributed to the
disaster, which killed 15 workers.
“The relationship of long hours, worker fatigue and
safety is a concern beyond medical residents, since there is extensive
evidence linking fatigue with operator error,” Michaels said.
safety is a concern beyond medical residents, since there is extensive
evidence linking fatigue with operator error,” Michaels said.
Additionally, the OSHA chief made clear that employers should bear the responsibility for the safety of their workers.
“All
employers must recognize and prevent workplace hazards — that is the
law,” he said. “Hospitals and medical training programs are not exempt
from ensuring that their employees’ health and safety are protected.”
employers must recognize and prevent workplace hazards — that is the
law,” he said. “Hospitals and medical training programs are not exempt
from ensuring that their employees’ health and safety are protected.”
He doesn’t have to convince the folks at Public
Citizen, SEIU or the American Medical Student Association. Those groups
spearheaded the petition to OSHA officials this week, calling on the
agency to assume the responsibility of monitoring the work hours of
medical residents.
Citizen, SEIU or the American Medical Student Association. Those groups
spearheaded the petition to OSHA officials this week, calling on the
agency to assume the responsibility of monitoring the work hours of
medical residents.
Current work-hour rules — which are established and
monitored by the Accreditation Council for Graduate Medical Education
(ACGME) — are simply too lenient to ensure the safety of physician
residents and the patients they see, the advocates argue.
monitored by the Accreditation Council for Graduate Medical Education
(ACGME) — are simply too lenient to ensure the safety of physician
residents and the patients they see, the advocates argue.
The stress and fatigue related to long hours not
only heightens the risk of depression and car wrecks, but can also lead
to medical errors, they say.
only heightens the risk of depression and car wrecks, but can also lead
to medical errors, they say.
“Working these
extreme hours for years at a time, predictably, has ill effects on
personal health and safety,” the groups wrote to Michaels.
extreme hours for years at a time, predictably, has ill effects on
personal health and safety,” the groups wrote to Michaels.
“For OSHA not to regulate resident physician work
hours is to abdicate its responsibility to protect the health of those
who care for the nation’s sick and dying.”
hours is to abdicate its responsibility to protect the health of those
who care for the nation’s sick and dying.”
Among
the new worker protections, the advocates are pushing OSHA (1) to limit
medical residents’ hours to a strict 80 per week (by contrast, ACGME
caps the workweek at 80 hours averaged over four weeks); (2) to limit
single shifts to 16 consecutive hours (whereas ACGME rules effectively
allow 30-hour shifts); and (3) to grant residents at least one full day
off per week, “without averaging” (ACGME rules also require one day off
per week, but average the provision over four weeks).
the new worker protections, the advocates are pushing OSHA (1) to limit
medical residents’ hours to a strict 80 per week (by contrast, ACGME
caps the workweek at 80 hours averaged over four weeks); (2) to limit
single shifts to 16 consecutive hours (whereas ACGME rules effectively
allow 30-hour shifts); and (3) to grant residents at least one full day
off per week, “without averaging” (ACGME rules also require one day off
per week, but average the provision over four weeks).
How OSHA responds remains to be seen. But Michaels said the agency is well aware of the issue.
“It is clear that long work hours can lead to tragic mistakes, endangering workers, patients and the public,” he said.
“No worker, whether low-skilled and low-wage, or highly trained, should be injured, or lose his or her life for a paycheck.”
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