You may not recognize this face, but if you end up in the hospital, you can thank her for your doctors being more refreshed.
"In the mid 70s, there was no regulation. Interns and residents routinely worked every other night on call, often with one day off a week. And it was extremely stressful," said Dr. David Duggan, Upstate Medical University College of Medicine Dean.
This is Libby Zion. The 18-year-old died in 1984 as a result of toxic drug interaction after doctors misdiagnosed her illness. In the investigation that followed, the mistake was attributed, in part, to exhaustion. The first year resident had been working for 18 hours straight at that time. Her death led to the Bell Commission, which restricted the amount residents can work to a maximum of 80 hours per week and no more than 24 hours at a time. Those were the first limits on residents' work hours.
Duggan said, "If you stay up too long and you're tired, you make more mistakes. Based on that type of evidence, there have been further restrictions placed on how long people can work."
This July, additional restrictions went in place. First year residents can't work more than 16 hours at a time. For second year residents, it's no more than 20 hours. Plus hospitals have to encourage rests and strategic napping.
"Certainly it makes sense that people should not work when they're exhausted and can't make good decisions. No one disagrees with that. You have people that say by increasing the number and frequency of hand-offs, you increase the number of mistakes made through the hand-offs and at some point, and at some point, that's going to equal out. But you also make it more difficult for physicians-in-training to see a whole case from beginning to end. They only see bits and pieces of it. So they learn less from it," Duggan said.
While the jury is still out on what this means for patient care, hospitals have been supplementing residents with other members of the health care team, like nurse practitioners or physicians assistants. And many believe that certain residencies can be accomplished in less time.