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Open Access Highly Accessed Research article

US public opinion regarding proposed limits on resident physician work hours

Alexander B Blum1, Farbod Raiszadeh2, Sandra Shea3, David Mermin4, Peter Lurie59, Christopher P Landrigan678 and Charles A Czeisler78*

Author affiliations

1 Department of Health and Evidence Policy, Mount Sinai School of Medicine, New York, NY USA

2 Division of Cardiology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA

3 Committee of Interns and Residents, SEIU Healthcare Division, Service Employees International Union, New York, NY, USA

4 Lake Research Partners, Berkeley, CA, USA

5 Public Citizen's Health Research Group, Washington, DC, USA

6 Division of General Pediatrics, Department of Medicine, Children's Hospital Boston, Harvard Medical School, Boston, MA, USA

7 Harvard Work Hours, Health and Safety Group, Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA

8 Division of Sleep Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA

9 Current address: US Food and Drug Administration, Silver spring, MD, USA

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Citation and License

BMC Medicine 2010, 8:33  doi:10.1186/1741-7015-8-33

Published: 1 June 2010

Abstract

Background

In both Europe and the US, resident physician work hour reduction has been a source of controversy within academic medicine. In 2008, the Institute of Medicine (IOM) recommended a reduction in resident physician work hours. We sought to assess the American public perspective on this issue.

Methods

We conducted a national survey of 1,200 representative members of the public via random digit telephone dialing in order to describe US public opinion on resident physician work hour regulation, particularly with reference to the IOM recommendations.

Results

Respondents estimated that resident physicians currently work 12.9-h shifts (95% CI 12.5 to 13.3 h) and 58.3-h work weeks (95% CI 57.3 to 59.3 h). They believed the maximum shift duration should be 10.9 h (95% CI 10.6 to 11.3 h) and the maximum work week should be 50 h (95% CI 49.4 to 50.8 h), with 1% approving of shifts lasting >24 h (95% CI 0.6% to 2%). A total of 81% (95% CI 79% to 84%) believed reducing resident physician work hours would be very or somewhat effective in reducing medical errors, and 68% (95% CI 65% to 71%) favored the IOM proposal that resident physicians not work more than 16 h over an alternative IOM proposal permitting 30-h shifts with ≥5 h protected sleep time. In all, 81% believed patients should be informed if a treating resident physician had been working for >24 h and 80% (95% CI 78% to 83%) would then want a different doctor.

Conclusions

The American public overwhelmingly favors discontinuation of the 30-h shifts without protected sleep routinely worked by US resident physicians and strongly supports implementation of restrictions on resident physician work hours that are as strict, or stricter, than those proposed by the IOM. Strong support exists to restrict resident physicians' work to 16 or fewer consecutive hours, similar to current limits in New Zealand, the UK and the rest of Europe.