To the Editor.—
Dr McCall1 begins his editorial in the February 10 issue of JAMA by citing the death of Libby Zion as the catalyst for the sweeping changes in residency training that are occurring in New York and around the country. No one doubts that her death indeed was the impetus for these changes. Similarly, most physicians involved in medical education probably agree that the new regulations that govern house-staff training in New York will improve the quality of life of interns and residents without severely affecting their learning (at least in my field, internal medicine). However, by accepting the causeand-effect relationship between long work hours and the death of a young woman, Dr McCall and others naively and irresponsibly ignore the major crises in health care today.Substandard care is being provided in hospitals all over the country (unfortunately, New York is probably a leader here as
Schluger N. Residents' Work Schedules. JAMA. 1989;261(24):3548–3549. doi:10.1001/jama.1989.03420240062015
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