New York teaching hospitals are exceeding state-mandated limits on the number of hours physicians-in-training are allowed to work each week, state health officials have discovered.
At a press conference late last month, Health Commissioner Barbara DeBuono, M.D., unveiled results of surprise inspections at 12 hospitals across the state. Hospitals' lack of compliance with an 80-hour limit on residents' weekly work schedules could compromise patient care, she said. The health department sent a total of 72 investigators to the 12 hospitals in early March (March 16, p. 20).
Late last month, the state dispatched inspectors to three more hospitals, although DeBuono would not say which ones.
New York is the only state in the nation that caps the number of hours medical residents may spend on the job. The limits were imposed 10 years ago after Libby Zion, the daughter of journalist Sidney Zion, died at New York Hospital. Her parents contended that her death was caused in part by overworked and undersupervised physicians-in-training.
In five days of observation and interviews this March, health inspectors found 37% of residents were clocking more than 85 hours per week. One in five residents puts in more than 95 hours per week.
Although the state did not disclose results of individual hospital inspections, DeBuono said none of the 12 facilities fully complied with state regulations.
She was particularly alarmed by what inspectors saw occurring in hospitals' surgical suites. Statewide, 60% of surgical residents worked 95 hours per week, with compliance varying widely across the state. In the New York City area, 77% of surgical residents were on duty for more than 95 hours at a stretch. Elsewhere in the state, 32% exceeded the 95-hour mark.
Despite those findings, the state is not imposing sanctions this time around. Hospitals could have faced fines of $2,000 per violation.
In addition to monitoring compliance with working hour limits, state inspectors checked to see whether residents received adequate supervision. In every instance, attending physicians were at hand or just a phone call away, as the state requires.