Whetsell Jennifer F
Ann Health Law. 2003;12(1):23-73, table of contents.
Ms. Whetsell examines the Bell Regulations, which limit New York's hospital residents' work hours and require increased supervision from senior doctors, in light of the currently pending federal bill that seeks to do the same. The article argues that the federal government should draw lessons from the New York experience before proceeding with similar guidelines. The article notes that many roadblocks have prevented successful implementation of the New York policy, including a long-standing tradition of "hazing" first-year residents with long, unsupervised hours; medical community resistance to the notion of residents' sleep deprivation and dislike of government interference; and a general fear within the medical community of increased medical malpractice liability and other indicia of "blame culture." The Article concludes that the most effective approach to patient safety related to residency sleep deprivation should work within hospital culture, not against it. The proposed alternative approach would encourage patient safety strategies that value teamwork and cross-discipline collaboration, and consequently result in greater satisfaction for residents, hospitals, and patients.
惠策尔女士结合目前正在审议的一项旨在限制纽约住院医生工作时长并要求增加资深医生监督的联邦法案，审视了《贝尔条例》。该文章认为，联邦政府在推行类似指导方针之前，应借鉴纽约的经验。文章指出，诸多障碍阻碍了纽约政策的成功实施，包括长期以来存在的让第一年住院医生长时间无人监督工作的“欺凌”传统；医学界对住院医生睡眠不足这一观念的抵制以及对政府干预的反感；以及医学界普遍担心医疗事故责任增加和其他“指责文化”的迹象。文章得出结论，与住院医生睡眠不足相关的患者安全最有效方法应在医院文化内部起作用，而非与之相悖。提议的替代方法将鼓励重视团队合作和跨学科协作的患者安全策略，从而为住院医生、医院和患者带来更高的满意度。
