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To the Editor.—
I agree with Ralph M. Stanifer, MD (242:745, 1979), that "interns and residents are at the same time both students and employees." However, there is no reason whatsoever to assume that declaration of resident costs as service, as opposed to education, is likely to dissuade the US Department of Health, Education, and Welfare from using this reimbursement lever for policy purposes, should the agency decide to do so to effect specialty or geographic distribution. House Bill 2222 cannot be supported with such an argument.Dr Stanifer's conclusion, that classification of house staff as primarily students would be detrimental, emanates from his recitation of several potentially adverse actions by state licensing boards, third-party payers, and others in response to such classification. The fact of the matter is that house staff members have been so classified all along, as borne out by the National Labor Relations Board's Cedar-Sinai ruling,
Challoner DR. Employment Status of House Staff. JAMA. 1980;243(14):1421. doi:10.1001/jama.1980.03300400011006