Several groups are speaking out against a proposal to allow new doctors to work up to 28-hour shifts — an idea that’s raised questions about patient safety, physician well-being and what’s necessary to train great doctors.

Supporters say boosting the maximum number of work hours allowed doesn’t affect patient care and can lead to better educational opportunities for new physicians, while critics of the proposal say it’s dangerous for patients and doctors

Those critics include advocacy groups Public Citizen, Care2 and the American Medical Student Association, which delivered a petition against the proposal Friday to the Accreditation Council for Graduate Medical Education in Chicago, which makes rules about physician residency programs. The petition had 67,000 signatures on it, gathered online from all over the globe.

First-year residents — doctors who just graduated from medical school and are training at hospitals — currently are limited to 16-hour shifts. The council’s proposal would raise that limit to 24 hours, the same limit in place for residents past their first year of training. It also would allow residents to work an additional four hours — for a total of 28 — if they wish, to follow through on patient care.

Young doctors could work 28 hours straight under new plan, despite risks Melody Petersen

The private group that oversees physician training in the United States has proposed rolling back rules so that young doctors just out of medical school can work shifts as long as 28 hours.

The proposal relaxes work restrictions put in place in 2011 when mounting evidence showed that exhausted…

The private group that oversees physician training in the United States has proposed rolling back rules so that young doctors just out of medical school can work shifts as long as 28 hours.

The proposal relaxes work restrictions put in place in 2011 when mounting evidence showed that exhausted…

(Melody Petersen)

The proposal also would eliminate the requirement that residents get at least eight hours off between shifts.

A current requirement that residents work no more than 80 hours a week, averaged over four weeks, would remain in place, and residents would still have to get at least one day off a week, averaged over four weeks.

Kelsey Bourgeois, who works for Care2 and whose husband is a first-year resident at Northwestern Memorial Hospital, said the proposal is bad for doctors and patients.

"These are 26-year-old new doctors supposed to work 28-hour shifts and provide critical care," Bourgeois said. "It just doesn’t make a lot of sense."

Her husband, Isaac Bourgeois, said the first year of residency can be overwhelming for doctors practicing medicine in real life for the first time. During his first days as a resident, "I was just mentally wiped out, just obliterated because it’s all new," he said.

Advocates of the proposal, however, say it’s a common-sense measure that could allow for better patient care and improved educational opportunities for young doctors.

Delivering petition Jose M. Osorio / Chicago Tribune Hannah Hughes, center, whose fiance is a first-year medical resident, walks with Jorge Arevalo, left, whose sister will soon be a first-year resident, and Jeff Horwat, whose wife is a first-year resident, on Feb. 3, 2017, as a medical student group delivers a petition to the Accreditation Council for Graduate Medical Education board meeting in Chicago. The petiton urges the board to reject a proposal to allow first-year residents to work 28-hour shifts. Hannah Hughes, center, whose fiance is a first-year medical resident, walks with Jorge Arevalo, left, whose sister will soon be a first-year resident, and Jeff Horwat, whose wife is a first-year resident, on Feb. 3, 2017, as a medical student group delivers a petition to the Accreditation Council for Graduate Medical Education board meeting in Chicago. The petiton urges the board to reject a proposal to allow first-year residents to work 28-hour shifts. (Jose M. Osorio / Chicago Tribune)

Dr. Karl Bilimoria put it this way: "If you had your surgery in the morning on a Monday and Monday evening you had a complication that required you going back to the operating room at midnight, would you want the on-call person there or the team that was there and did your first operation in the morning who knew everything that happened and had a relationship with you?

"Things get lost when doctors hand things off to each other," said Bilimoria, director of the Surgical Outcomes and Quality Improvement Center at Northwestern University’s Feinberg School of Medicine.

A study conducted at 151 hospitals across the country found no difference in patient outcomes, regardless of whether doctors were allowed to work 16 hours or 28 hours. The results of the study were published in the New England Journal of Medicine last year.

Bilimoria, the principal investigator in that study, said many residents are in favor of allowing for longer hours, noting that residents are allowed to sleep during their shifts when there’s downtime. The study found that surgical residents reported no decrease in morale or their personal safety when they were allowed to work the longer hours.

The council’s proposal has been in the works for more than a year. It began reviewing the hour requirements as part of a five-year scheduled review. It solicited public comments and got position statements from more than 60 organizations.

If the council approves the proposal, it means new doctors will revert to longer hours similar to those allowed before 2011. The council lowered the maximum in 2011 to 16 after recommendations from the Institute of Medicine, which worried fatigue would put patients’ safety at risk and undermine residents’ learning experiences.

The board is expected to vote on the measure sometime this year.

lschencker@chicagotribune.com

Twitter @lschencker

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