Michelle Au on seeing the attending when visiting a teaching hospital:
But then when it comes time for my family to come into the hospital, or if my child gets sick, I don’t want to buy into the system of which I myself am a part. I want to skip to the top. I want the attending. And not even just any attending, I want the senior attending. I want the one with the grey hair and the 30 years of experience who trained in the days of the giants and who has seen everything at least 600 times before. I will let med students in the room and I will chat with the intern and I will let the residents do whatever scut needs to be done, but when that needle’s coming at my back, or when (god forbid) it’s my child going under the mask, I want the very best, most experienced person to be involved.
(via a reader tip)
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{ 11 comments }
Everyone wants well trained doctors, but nobody wants to be trained upon.
I don’t mind being trained upon as long as “the one with the grey hair and the 30 years of experience who trained in the days of the giants and who has seen everything at least 600 times before” is awake, sober, and in the room.
I have had a few medical students practice on me and everything went well.
But then, I’m a good teacher!!
In a teaching hospital the guy with grey hair and 30 years of experience has spent the last 20 years of his career supervising other doctors and probably doesn’t even know how to work a vacutainer, much less do a lumbar puncture. Now that’s different from someone who has spent 30 years in private practice and not had the luxury of house staff.
Personally, I’d rather have the senior resident working on me. He has a vested interest in me leaving the service alive in a short time.
In a hopsital with house staff, the attendings are either glorified house staff or useless
I want the senior resident, fellow, or new attending doing the fancy procedure, while the guy with the grey hair double checks their judgement on whether it is really worth doing or not.
A good teaching hospital is culture in which their is a complex synergistic relationship between the speed and agility of youth and the cunning and gravitas of age.
I want the senior resident, fellow, or new attending doing the fancy procedure, while the guy with the grey hair double checks their judgement on whether it is really worth doing or not.
A good teaching hospital is culture in which their is a complex synergistic relationship between the speed and agility of youth and the cunning and gravitas of age.
I want a medical student who likes me and is interested and pulls everything together and pesters the resident and attending with obnoxious questions that keep them paying attention to my case.
You and I must have trained in different teaching hospitals. The sharpest attendings are in their early 40’s or 50’s and are usually part-time academics. I would never want the lab guy who does teaching rounds one month a year doing anything on me. Or honestly making the decision. I know specialty attendings who are listed in the “top 100″ in our city who don’t see the patients the service staffs with them.
Unless you know the department intimately (and they know you the same way), you’ll get the same random luck that everyone else gets–whatever attending is on that month. And if you complain that you don’t want to talk to the student/resident/fellow they will all hate you, including the attending. It is bad when your providers hate you. I’m sure there is evidence to support that.
To all the patients (and entitled VIPs) out there who are smart enough to go into an academic hospital, here is what you should do: be nice to the medical student/resident/fellow and answer all of their question with facts and brevity. Smile. You will be one of the few on the service who provide them with this simple pleasure and I guarantee you will get the best service.
b
Ha Ha Wrong! Everyone knows: “Never let the chairman operate on you.”
Throughout my training, the chairmen where little more than paper publishers and political back-slappers: way past their surgical prime.
One of the junior attendings “in the trenches” is the way to go.
Your story reminds me of the old chair of the orthopedics department at UCLA. Had his name on every single paper published out of that department and didn’t put in one lick of work.
~Crminallopath~
anon 6:55pm -
well put. I always love when non-medical people say “my doctor was rated one of the TOP DOCTORS in blah magazine”, or “if I need surgery I’m having the CHIEF of the department performing it”.
What clueless idiots. If it’s me I want the guy who is the workhorse for whatever I need, typically the guy in his 40s who is smart, current, and technically well-practiced recently. THat’s true for cardiac cath, orthopedic surgery, and even keeping up with current recommendations in primary care medicine.
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