New York state's continuing crackdown against teaching hospitals that overwork young physicians-in-training resulted in another fine last week, and many more penalties are expected before the dragnet is over.
The state Department of Health slapped Brooklyn (N.Y.) Hospital Center with a $14,000 fine for exceeding state mandated limits on the number of hours residents are permitted to work. Earlier this summer, the state identified similar problems at New York University Medical Center in New York City and assessed a $16,000 fine.
By next May all of the more than 100 teaching hospitals in the state will be surveyed for potential violations, said Frances Tarlton, a health department spokeswoman.
It's been 10 years since the state imposed limits on residents' working hours, but only now are they being rigorously enforced. Prompted by the death of journalist Sidney Zion's daughter, Libby, the regulations are intended to protect patients from physicians who are tired, overworked and undersupervised. Libby Zion's parents charged that such factors contributed to her death.
The state conducted surprise inspections of 12 teaching hospitals earlier this year and found that many residents were clocking more than 85 hours a week (June 1, p. 28).
Under state hospital code, residents may work no more than 80 hours a week averaged over a four-week period and no more than 24 hours straight. Although no fines were assessed earlier this year, the health department warned that it would do follow-up surveys and assess maximum penalties of $2,000 per violation.
State inspectors returned to Brooklyn Hospital May 18, June 20 and June 21 to find:
Twelve of 14 surgical residents working in excess of 85 hours a week.
All 14 surgical residents working 30 to 36 hours without a break.
Two of five obstetrician/gynecologists working 29 to 34 hours straight.
On-call residents lacking adequate rest due to frequent interruptions for patient-care responsibilities.
The hospital's plan of correction calls for revisions in resident working schedules and cutbacks in operating room hours. It also has hired additional hands in surgery and OB/GYN.