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Comment & Response
October 28, 2013

Duty Hour Reform: Only a Small Piece of a Larger Problem—Reply

Author Affiliations
  • 1Department of Psychiatry, University of Michigan, Ann Arbor
  • 2Department of Pediatrics, Keck University of Southern California (USC) School of Medicine, Los Angeles County + USC Medical Center, Los Angeles
  • 3Department of Medicine, Keck USC School of Medicine, Los Angeles County + USC Medical Center, Los Angeles
  • 4Department of Internal Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
JAMA Intern Med. 2013;173(19):1844-1845. doi:10.1001/jamainternmed.2013.9710

In Reply We agree with Dr Runyan that addressing interprofessional communication and handoff training are critical factors in achieving meaningful improvement in both the quality of care that residents provide and the quality of life that they enjoy. Evidence from multiple studies indicate that the most recent set of Accreditation Council for Graduate Medical Education duty hour reforms, which focused almost exclusively on reducing maximum shift length, have not achieved the intended improvements in quality of care or quality of life.13 If this experience with interns is instructive, then extending work hour limits to all residents, without addressing the additional factors raised be Dr Runyan, will likely be ineffective.

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