Remembering the patient whose case triggered duty hour reform

By: Julie McCoy March 3rd, 2009

This week marks the anniversary of the death of Libby Zion. Even if you don’t know who Libby Zion is, you’ve definitely seen the effects of her passing-her case thrust the issues of resident supervision and long resident work hours into the national spotlight.

Zion went to the emergency room in 1984 with a high fever and irregular jerking movements, and she later died. After an investigation, her family discovered she was treated by residents who had been up for hours and had an overwhelming amount of patients to care for. The family launched a public crusade to make sure these issues were addressed.

Although it took nearly a decade for the ACGME to implement duty hour standards, Zion’s case is widely accepted as the impetus for the reform.

In the New York Times this week, columnist Pauline Chen wrote two articles I definitely recommend reading:

On Young Doctors and Long Work Days, which includes a Q&A with ACGME CEO Thomas J. Nasca, MD about duty hour concerns and the future of reform after the recent IOM report
A Life Changing Case for Doctors in Training, which takes a look at the Zion case and how far regulations have come since her death.

Also, check out the comments related to the first article. They offer really interesting insights from residents, patients, and physicians.

What do you think about where duty hour reform is headed? Do you agree with Nasca’s comments?