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Letters to the Editor  |   July 2006
Violations of the 80–Duty-Hours Work Standard to Be Investigated
Author Affiliations
  • MICHAEL I. OPIPARI, DO
    American Osteopathic Association's Council on Postdoctoral Training Chicago, Ill
    Chairman
Article Information
Medical Education / Professional Issues / Graduate Medical Education
Letters to the Editor   |   July 2006
Violations of the 80–Duty-Hours Work Standard to Be Investigated
The Journal of the American Osteopathic Association, July 2006, Vol. 106, 428-429. doi:10.7556/jaoa.2006.106.7.428
The Journal of the American Osteopathic Association, July 2006, Vol. 106, 428-429. doi:10.7556/jaoa.2006.106.7.428
To the Editor: As chairman of the American Osteopathic Association's (AOA) Council on Postdoctoral Training, I feel compelled to express my gratitude to Susan C. Zonia, PhD, and colleagues for their July 2005 article on the duty-hour standards that became effective for all accredited residency programs in 2003 (J Am Osteopath Assoc. 2005;105:307–331). My thanks extend also to Brian H. Foresman, DO, for his accompanying editorial (J Am Osteopath Assoc. 2005;105:305–306). Both pieces well reflect the extreme significance of the duty-hour work standards imposed on all internship and residency programs approved by the AOA and accredited by the Accreditation Council for Graduate Medical Education. 
Initially, the medical profession was flooded with anxiety, questions, and uncertainty about these restrictions. In the past several years, however, a casual attitude toward resident duty hours has regained an unfortunate foothold in some of our training hospitals, and I believe the issue is no longer given the seriousness it deserves. In these days of commitment to patient safety through the landmark Institute of Medicine report,1 the Institute for Healthcare Improvement's 100K Lives Campaign (see http://www.ihi.org/IHI/Programs/Campaign),2 and tightening hospital accreditation standards,3 how can anyone deny the need for duty-hour regulations in physician training? 
No one is yet certain of the impact of this restriction on the quality of physician training. But who can doubt its benefit to resident health, improved alertness on duty or in lectures and at conferences, and improved attitudes toward learning opportunities. 
Modifications may well yet have to occur to training models to compensate for potential loss of continuity and volume—if, indeed, that result can be validated. However, until data are available, the validated benefits of sleep, rest, and personal time are as applicable to physicians-in-training as they are for the patients for whom we care and advise. 
The Council on Postdoctoral Training encourages residents to report duty-hour violations anonymously to the AOA through the association's toll-free Postdoctoral Program Violation Hotline at (877) 325-8197 or by e-mail at postdoc@osteopathic.org. Such violations are and will continue to be investigated seriously to preserve the educational benefits for residents, the safety of patients, and the quality of training programs. 
Kohn LT, Corrigan JM, Donaldson MS, eds; for the Committee on Quality of Health Care in America. To Err Is Human: Building a Safer Health System. Washington DC: Institute of Medicine; 2000. Available at: http://darwin.nap.edu/books/0309068371/html/. Accessed April 18, 2006.
American Osteopathic Association. The AOA and HFAP endorse the Institute for Healthcare Improvement “Save 100,000 Lives” campaign. HFAP News. July 2005;7:5–6. Available at: http://www.do-online.osteotech.org/pdf/acc_hfapnews0805.pdf. Accessed June 20, 2006.
Healthcare Facilities Accreditation Program. Accreditation Requirements for Healthcare Facilities, 2005. Chicago, Ill: American Osteopathic Association;2005 .