Attending Physician Teaching and Supervision Responsibilities
Conduct teaching or management/teaching rounds with the house staff at least seven hours per week and assist with any problems that arise. These rounds should not interfere with morning report or noon conference and must include case presentations, interpretation of data, discussion of pathophysiology, differential diagnosis, management, use of technology, use of best evidence and patient values in decision making, disease prevention, and bedside teaching. The RRC mandates that 75% of rounds should include direct resident and attending interaction with patients with less than 25% permitted as "card flip" exclusively.
Attending physicians should also:
- Review the rotation curriculum with the housestaff at the beginning of the month. The curriculum is available on line and is emailed to each attending at the beginning of the month.
- Supervise and teach team members. Review and critique medical students' and housestaff's history and physicals, daily progress notes, and oral presentations.
- Accept medical responsibility for the care of patients assigned to the service. Write a brief admit note on all patients within 24 hours of admission documenting that the patient has been examined, the housestaff documentation has been reviewed, and recommending any changes in assessment or management. Both MUH and the Med strongly encourage daily progress notes. The VAMC requires at least one note per week.
- Be available by pager at all times to assist housestaff and be available in person if requested. Attempt to be present during procedures.
- Provide feedback to both students and house staff mid-month and at the end of the rotation. If a team member's performance is unsatisfactory, it is the duty of the attending physician to notify the student or housestaff officer as soon as a problem is noticed to provide the team member ample opportunity for improvement.
- Administer a quiz to team members based on curriculum topics covered during the month.
- Patients Admitted by the Night Float Service:
All patients will have a Ward Service Attending Physician assigned at the time of admission. This Department of Medicine Attending Physician should be called to discuss any questions regarding patient care and must be notified promptly whenever any patient is clinically unstable or is moved to a higher level of care, has a major change in status or is made DNR.
- Patients Admitted to the Medicine Service:
The Department of Medicine Attending Physician for the patient should be called to discuss any questions regarding patient care and must be notified promptly whenever any patient is clinically unstable or is moved to a higher level of care, has a major change in status or is made DNR.
- Consult Service (MOD):
The General Internal Medicine (GIM) Attending Physician on call should be called to discuss any questions regarding patient care and must be notified promptly for any consults that: are going to the operating room, are clinically unstable, are moved to a higher level of care, or have a major change in status.