Compliance with the 24-hour, in-house attending coverage requirement : a survey

Fifty-six residency training programs in Region I Council of Resident Education in Obstetrics and Gynecology/Association of professors in Gynecology and Obstetrics were surveyed for compliance with the 24-hour, in-house attending coverage requirement, which took effect july 1991. Forty-six program directors responded to a questionnaire, for a response rate of 82.1%. Each had plans to implement this coverage in the 1991-1992 academic year. Two programs were unable to implement coverage because of inadequate financing or insufficient staffing. There were no differences in the types of programs (community, university, public or private university, or New York State program) in respondents as compared to non respondents. All the programs had overnight staff coverage for an average of 13 hours (range, 12-15) and had 24-hour, continuous coverage on the weekend. There was a wide variation in the attending/resident ratio. Twenty-eight programs (60.8%) reported that they compensated their attendings. Revenue for this compensation came from the hospitals (14), direct billing (8), faculty practice plans (6) or New York State (3). Of the 28 programs that offered compensation, 20 were private community hospitals, 6 were private university programs, 1 was a public university program and 1 was a public community hospital. Of the 28 programs compensating faculty, 17 were able to cite figures that had been approved by their respective institutions or practice plans. The annual cost ranged from $130,300 to $901,887 per program for institutions that compensated their attendings (mean, $340,402)