Not every attending. Not most. A tiny minority, to be sure.

But enough to warrant multiple Department of Justice Medicare Fraud Task Forces. Enough to support hundreds of false claims act suits and settlements every year.

I had one case where the residents hated the attending so much they kept a log of every fraudulent bill. And, no, they didn’t keep a long of primary care exemption work. They kept a log when they did the work and knew of the attending billing it himself.

Do you have any clue what you’re talking about? Are you seriously telling me billing fraud doesn’t exist?

1: Residents are trainee’s under an attending. I have never heard of them being considered at the same level of an attending. Every state I have ever worked in has specific resident licenses where they can only work under attendings in a supervised (the training hospital) setting. Yeah, bottom feeders will name residents and anybody else in the chart in a claim but the residents will typically get dropped unless acting beyond their scope of training. Perhaps at the end WC can talk about why the resident was in court but not the attending. Frankly, it doesn’t make sense

2: “Often, the “supervising” attending bills the insurer / government for the work they didn’t do”

How often is often Max? Do you have any clue or are you talking about or are you just once again spouting off uninformed BS. Ever heard of the primary care exemption? Sheesh.

Depending on the residency, some utilize their residents more than others. Surgery for one usually uses all 80hrs/week. Some places make sure the resident “averages” 80hr per week so might work 60 one week and 100 the next, as long as it averages out to 80/week. This is also why moonlighting can be difficult because while you work 60hrs this week and plan on 20 somewhere else, if your Program Director says hey I need you an extra shift next week you didn’t do all 80hrs anyway you would have to tell them no and if you are in a no moonlighting contract well, you can imagine.

Yes after 10 hrs some people are less able to perform, but this is why they implemented these regulations because of the critical mistakes being made. Also some residencies are longer thus the 80hr/week requirement doesn’t require them to have any less experience.

New rules, in general, say that residents are limited to working 80 hours a week, in some cases averaged over four weeks, and can work for no more than 24 hours at a stretch. They are to be on-call no more than every third night, must have 10 hours off between shifts and one day in seven free of all duties. The standards are set by the Accreditation Council for Graduate Medical Education (ACGME).

How often do they work 80 hrs/week? how often are they at the hospital for 24 straight hours with a chance to sleep? Is it possible that they sleep for part of that 80?

Do they usually do 80 hours for their entire residency?

I know that I am unable to think at work after about 10 hours. My mind shuts down completely. A couple of days of that and I’m fried. It is amazing people are expected to try and make life critical decisions like this.