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To the Editor While we acknowledge the need for evidence-based work hour reform, we would point out that the recent study on duty hours1 only addresses a small portion of the larger dynamic at work that contributes to medical error and intern and resident quality of life.
Integrated efforts by medical schools and teaching hospitals to address issues such as emotional burnout, better handoff techniques, and interprofessional communication are necessary to further a safe environment for both physicians and patients alike. It is not likely that depression scores will decrease, or patient safety will improve, until the residency training process is addressed in a systematic fashion, eg, more support staff, trainings on culture of medicine and breaking down reporting hierarchies, time for reflection and improvement, and better handoff training.
Runyan A. Duty Hour Reform: Only a Small Piece of a Larger Problem. JAMA Intern Med. 2013;173(19):1844. doi:10.1001/jamainternmed.2013.9721