The New York health department is investigating whether academic medical centers are overworking medical residents or failing to adequately supervise them.
The investigation, which will extend to more New York teaching hospitals in coming months, is unprecedented in graduate medical education.
"Clearly it's a nationwide issue," said Robert Dickler, senior vice president for the Association of American Medical Colleges. "The association and the medical community have said residents should not work excessive hours and should be adequately supervised."
The health department sent a total of 72 inspectors to 12 hospitals March 5. While state officials used the element of surprise, the investigation had been in the works for months, said Bob Hinckley, a department spokesman.
"There was a common thread we were seeing arise out of some complaints we were getting, complaints that the residents treating patients were overworked or unsupervised when treating patients," Hinckley said. "We chose a random sampling of academic medical centers and teaching hospitals for the first phase."
An 8-year-old state law prohibits residents from working more than 80 hours a week. Residents may not work more than 12 hours straight in the emergency room or more than 24 hours consecutively in a medical ward. They also are expected to have close consulting relationships with their supervisors, usually senior physicians who offer advice on diagnoses and treatment.
The investigation, which also is looking at how residents are supervised, will spread to more of the state's teaching hospitals in the coming months, Hinckley said.
It's hard to say whether similar probes will be done in other states, Dickler said. "New York has passed a law and provided financing for it, so there's a context for pursuing this that doesn't exist elsewhere."
The Healthcare Association of New York State, a lobbying group representing hospitals and health systems statewide, said the health department is responding to political pressure from other officials, including New York City's public advocate.
"The health department has been under fire . . . for doing announced surveys and for residents' hours, so they decided they needed to take a look at this," HANYS spokeswoman Jeannie Cross said.
The health department began reviewing its findings after its surveys of the 12 hospitals ended last week. It will report back to the hospitals. Violations could result in citations or other actions, Hinckley said.
Cross was confident the department would cite any violations uncovered, but remained unfazed about the first round of surprise visits: "No one came out on (last) Monday with hideous violations."