To the Editor: In their Commentary on building physician work hour regulations using first principles and best evidence, Drs Volpp and Landrigan1 offer 3 possibilities to explain the inconsistent benefits observed in studies to assess the effect of reduced house staff work hours: the work rules either are not restrictive enough, are inconsistently applied, or are thwarted by poor transition practices. The authors dismiss what must be the first consideration in scientific inquiry—that the hypothesis on which the original changes were based was incorrect.
Rice LB. Evidence-Based Evaluation of Physician Work Hour Regulations. JAMA. 2009;301(5):484-485. doi:10.1001/jama.2009.43