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June 20, 1990

House Staff Supervision and Working HoursImplications of Regulatory Change in New York State

JAMA. 1990;263(23):3177-3181. doi:10.1001/jama.1990.03440230073036

In July 1989, New York State adopted new rules that limit the hours worked by residents and mandate continuous, on-site supervision of junior residents. In addition, all New York hospitals must provide 24-hour coverage for intravenous, phlebotomy, and messenger/transporter services. This article examines the impact of New York's landmark changes on hospital staffing, graduate medical education, the demand for ancillary personnel, and hospital expenditures. Based on a statewide survey, the results indicate that implementation of these rules would require hospitals to hire an additional 5358 full-time equivalent personnel at a yearly cost that would exceed $358 million. The broader implications of these rules on financing graduate training are also explored.

(JAMA. 1990;263:3177-3181)