The letter—addressed to Thomas Nasca, executive director and CEO of the Accreditation Council for Graduate Medical Education, and Rep. Henry Waxman (D-Calif.), chairman of the House Energy and Commerce Committee—has already been signed by some 48 patient-safety and consumer advocacy groups.
“Given press reports over the past year highlighting the academic medical community's criticisms of the IOM recommendations … we are fearful that the ACGME will choose not to adequately act on the evidence at this critical juncture,” the letter stated.
Charles Czeisler, director of the division of sleep medicine at Harvard Medical School, said there is “widespread falsification” of work-hour records. ACGME spokeswoman Julie Jacob told Modern Healthcare that every complaint about noncompliance with work-hour limits is investigated.
It has been estimated that implementing the work limits recommended by the IOM could cost the U.S. health system up to $1.7 billion, but Czeisler, who testified before the committee that developed the IOM recommendations in 2008, said a cost-benefit analysis was done that showed this could be offset with only a 10% reduction in fatigue-related errors based on the premise that each mistake resulted in an additional $5,000 to $6,000 in costs.
The ACGME board is currently meeting with its work-hours task force in Scottsdale, Ariz. Jacob said there is no firm timetable for updating the limits that were set in 2003, but one scenario had the board releasing proposed changes for public comment after a tentatively scheduled June 19 teleconference, and then voting on final rules after its fall meeting tentatively scheduled for Sept. 27-28. An implementation of those rules could occur in July 2011 at the earliest, she said.
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