Legislation that would make resident work hour restrictions, similar to those implemented this summer by the Accreditation Council for Graduate Medical Education (ACGME), the law of the land was introduced in Congress in the spring.
On March 12 Rep. John Conyers, D-Mich., introduced H.R. 1228, the Patient and Physician Safety and Protection Act, and on April 30 Sen. Jon Corzine, D-N.J., introduced the companion measure, S. 952. Neither bill has any additional cosponsors at press time. This legislation was first introduced last year, but died when the 107th Congress adjourned.
Although passage of either bill during the 108th Congress is unlikely, particularly in light of the fact that the ACGME now has implemented its own regulations, enactment would require hospitals to establish limits on working hours for certain members of the medical staff and post-graduate trainees (defined as postgraduate interns, residents or fellows) as a condition of participation in the Medicare program.
Key provisions would require:
- limiting call to no more than every third night;
- limiting work hours to 80 hours per week and no more than 24 hours per shift; at least 10 hours between shifts; and
- at least one full day out of seven off and one full weekend off per month.
The Department of Health and Human Services would be responsible for developing regulations related to the transfer of patients from one resident to another at the end of each 24-hour period.
Penalties for noncompliance would be steep. Any hospital that violates the law would be subject to a civil penalty of up to $100,000 for each residency training program in violation during any six-month period.
The proposed legislation is consistent with the new ACGME duty hour requirements, however the ACGME rules are a bit more flexible as they allow for, among other things, a limited exception to the 80-hour limit.
- To get a copy of the Patient and Physician Safety and Protection Act, go to: https://thomas.loc.gov. Once there, enter “H.R. 1228” or “S. 952” in the Bill Number box.
Katie O. Orrico, JD, is director of the AANS/CNS Washington Office.