N.Y. Rules: Needed Reform

John D. Rasmussen, M.D

To the Editor

The New York State Regulations regarding work hours, resident supervision and anesthesia monitors are very interesting from at least two aspects. The first is that these reforms did not appear to be motivated by any compassion for the poor exhausted individual struggling to maintain some standard of quality care in the face of inadequate supervision. Rather, the motivation appears to have developed only when the problem became painfully clear in the form of poor patient outcome. What a terrible commentary on our teaching programs when they are more interested in squeezing every last bit of service from the student than in providing the best possible quality of instruction.

The second area of interest is the apparent surprise and shock that the cost of these reforms win be in the range of $200 million. For the most part, these are not new services that will have to be provided. These are services that are already provided although without compensation. So now the society that has so casually exploited the-se people in training will have the opportunity to actually put a price tag on their efforts.

New York State is to be applauded for these reforms. They demonstrate a recognition of the full responsibility of our society to train our medical people and care for our sick. In my opinion, they do not go far enough in that requiring 24 hours of continuous care is still unreasonable, although it is a start. Certainly these regulations should be made universal in the entire country.

John D. Rasmussen, M.D. Sacramento, CA