Before the Joint Committee on Public Health
The Massachusetts Medical Society is opposed to Senate Bill
1142, legislation that would lock into statute specific standards
currently established for resident-physician work hours and then
establish an Advisory Council on Physician Work Hours in the
Department of Public Health with authority to study resident
working conditions and make recommendations to the Department
regarding creating evidenced-based standards regarding duty hours
and working conditions. This committee would be limited in
its recommendations by the standards that would be set into
statute.
The Massachusetts Medical Society has been long concerned with
the working conditions of resident physicians - potentially placing
both them and their patients at risk - and has been committed to
change those conditions. Dating back to 1997, the MMS has
adopted policy supporting "the right of residents to negotiate
collectively on behalf of their colleagues . . ." as a means
of improving their working conditions. Over the years that
policy has been expanded by the MMS House of Delegates, which
agreed that:
"resident physician work hour excesses can negatively
impact patient safety, the quality of patient care and resident
physician health, safety, and well-being" and encouraged "all
residency program directors in Massachusetts to adopt resident
physician work hour standards that:
- limit resident physician work hours to 80 hours per week
- limit individual shifts to 24 hours
- require one in seven days off
- limit call to once every three nights"
A further Resolution requires the Society to "advocate for the
development and implementation of a national confidential and
anonymous channel through which residents and fellows can safely
report residency and fellowship program non-compliance with
regulations regarding resident and fellow work hours and work
conditions."
These policies and actions demonstrate a strong commitment to
creating more reasonable residency working conditions in
Massachusetts that meet the needs of resident physicians and their
patients, without compromising the highest standards of medical
education.
A more recent positive development has been the Accreditation
Council for Graduate Medical Education's (ACGME) implementation of
guidelines regulating resident working hours and conditions.
Most encouragingly, the Council has taken action against
high-profile non-complying programs. From the MMS
perspective, significant changes have taken place and are
continuing to occur regarding controls and oversight of resident
work hours.
While this legislation may become necessary in the future, its
present need has yet to be demonstrated. The MMS believes
that the ACGME should continue to be given the opportunity to
enforce its guidelines before the Commonwealth steps in. The
legislative and regulatory processes could inadvertently lock into
place hard to change across-the-board standards that prove to be
inappropriate to specific medical specialties, or, that are
incompatible with changing national standards. So long as
real progress is being made towards resolving this issue through
non-governmental means, the MMS urges the Committee to take a "wait
and see" stance.
We urge the Committee to report out this measure as "ought not
to pass" at this time.
