Residency reformerBertrand Bell

A New York City medical doctor, Bell was concerned with safety, for instance advocating for seatbelts in taxis and better training for paramedics. Perhaps his most urgent cause: limiting the hours that medical residents and interns had to work. At the time, it was common for such still-in-training doctors to work 36-hour shifts, catching naps when they could (and they were often too busy to get much sleep); they typically worked 95 hours per week, and often had no senior doctors supervising them. “How is it possible for anyone to be functional working a 95-hour week?” Bell demanded. “A bus driver can’t do it. A pilot cannot do it. So why should a neophyte doctor do it?”

Things came to a head when two overworked and unsupervised residents were held responsible for the death of 18-year-old Libby Zion in 1984. She happened to be the daughter of lawyer-writer Sidney Zion, who sued the doctors and the hospital. The state health commissioner appointed Dr. Bell to head a panel to suggest reforms. His panel recommended better supervision for interns and residents, a limit of 80-hour weeks, and a limit of 24 hours on call. The recommendations were adopted in 1987 by the New York Health Department, and then by the national Accreditation Council for Graduate Medical Education — but were still resisted or even ignored by many hospitals, citing staff shortages. Even Bronx Municipal Hospital Center fired Bell; he went on to teach medicine at the Albert Einstein College of Medicine. Dr. Bell died at home on October 4, from kidney failure. He was 86.

From This is True for 9 October 2016