The Medical Resident Working Hours Debate: A Proposal for Private Decentralized Regulation of Graduate Medical Education

Abstract

This Article examines and evaluates the costs and benefits of allowing certain bodies to regulate physician residency programs. Although most scholarship has promoted regulation either by governmental entities, the ACGME, or residents themselves, none of these groups is suited to this task. I argue that the ideal regulatory system should involve a decentralized private sector approach, achieved by ending the ACGME monopoly over graduate medical education accreditation and allowing for multiple graduate medical education accrediting agencies. Switching to a private decentralized system would allow for greater experimentation, which would increase the likelihood of discovering the best way to regulate resident working conditions to enhance patient safety, as well as preserve health professional control over the process.