Residency

The debate continues: The high costs of new duty hour standards

Residency Program Alert, July 1, 2009

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In December 2008, the Institute of Medicine (IOM) released a report, Resident Duty Hours: Enhancing Sleep, Supervision and Safety, recommending new duty hour standards and estimating the cost of implementing the suggested reforms at approximately $1.7 billion per year, with a potential range of $1.1 billion–$2.5 billion annually.
That’s about $3.2 million annually per teaching hospital, says Teryl K. Nuckols, MD, lead author of a new cost analysis study that takes a closer look at the IOM’s numbers, internist at the David Geffen School of Medicine at University of California, Los Angeles, and researcher at the RAND Corporation. Although the IOM’s recommendations have not yet been adopted by the ACGME, GME educators who experienced the 2003 rollout of the current standards know that complying with new duty hour rules isn’t cheap. In addition, most institutions don’t have an extra $3.2 million burning a hole in their budgets or much tolerance for another unfunded mandate, as many felt the 2003 standards were. The big unanswered question is: Will teaching hospitals have to shoulder the cost of implementing new standards, and if not, who will?

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