Supervision, not regulation of hours, is the key to improving the quality of patient care

This week's issue ofThe Journalhas an article by Laine et al,1which elegantly demonstrates how to study the effect changes in the working hours of residents will have on residency programs. The publication of this article is also evidence of wide interest in the 19-month study of a New York committee, the Bell Committee. The study produced a series of recommendations2that led to changes in the New York State Health Code,3regulating not only the working conditions of residents, but also their supervision.4 See also p 374. The need to rationalize the hours that house staff are scheduled to work, which has made sleep deprivation and chronic fatigue features of graduate medical education both in our country and in other countries, is a need whose time clearly has come.5In the United Kingdom, the Ministerial Group on Junior Doctors' Hours has accepted