Teaching hospital question- do attending physicians usually do rounds?
 

Is it typical for attending physicians at a teaching hospital to do rounds, or do they usually just send their senior residents and their underlings to do the rounds?

My wife just had a pretty major surgery at our local teaching hospital. There were two teams of doctors and their associated residents who performed the surgery. Everything went well and we were well informed on her progress during surgery but we were surprised that in the 3 nights that she stayed in the hospital, the attending physicians never showed up to do rounds in the morning. Is that typical? If so, seems like a sweet gig, you perform or oversee the surgery and then get to skip the early morning rounds. If it's not typical, is that poor form on the doctors' part? Just curious.

I have to say that the nurses were really great and caring. That's truly a calling and admirable. I can't imagine caring for sick people as a profession. Discharge is today, so time to become the caregiver.

Neil

The residents round on them and present it to attending and other residents, or that is how it was done in the olden days

Not sure about what is happening today.

My only personal experience is not with patient rounds, but with Grand Rounds-- I gave Grand Rounds at what was then St. Luke's Roosevelt Radiology Dept. back in 1986.

Here is a 21st century JAMA article that may help you learn more:

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1685887

I have often found that the references in such papers lead quickly to getting better-informed, especially when it is clear that there are folks in the references that one can quickly conclude are experts that frequently publish good studies.

As once pointed out to me by a long time employee of a "teaching hospital", the quick determination of a who's who is quicky ascertained by observing the length of their coats.

TV show House, he argued with them all the time

That is pretty common. The residents round and show up in the OR to update the surgeon. I don't see surgeons go see the patients unless something goes wrong.

And to be clear: there is a good chance one of the residents coming around actually performed the surgery.

Hope your wife has a speedy recovery.

Most all civilian hospitals have interns, student nurses and other students. The most unusual I had was when I had my stroke and the head of the stroke department looked like she was 16 or something and she always had 8 or so students that would always come in first and she would sort of hang back. Generally one student would do the talking/testing/etc, others just watched.

I had a lot of fun with "candy stripers" or student nurses. They would generally have their list of things they had to get done each shift so that worked well.
John

In the case of my FILs cardiac surgeon, he’s known to be a real a**hole with no bedside but the best in the area.

Would imagine the only time he wants to see anyone is when they’re under his knife.

I had inter-medullary nailing done to my femur a couple years ago.
Saw a dr. just before the surgery....none after...then they discharged me.

Every hospital/service has their own peculiarities. (One attending or all attendings? Attendings present for the morning rounds, or the afternoon ones?) But usually in a teaching hospital there are formal rounds twice a day. An intern or resident will pre-round in the early morning. Then the team of residents will go bed-to-bed to round on all the patients. That is often done with at least one faculty member, though not necessarily the one that operated on you. On other services, all attendings are present.

Then, the team of interns/residents/students disperses to get all the work done.

In the afternoon, a second rounding is done before people go home for the day. Again, an intern or resident will see each patient to pre-round and gather all vital info. Then the team will assemble and either go patient-to-patient or (perhaps more commonly in the afternoon) sit down to "run the list" and maybe see only the patients with problems/issues. It's in the afternoon rounds that a sign-out list is given to whomever on the team is on-call for the night.

It is customary for the attending of record (or one of his/her partners) to stop by at least once per day to see the patient, face-to-face. They may write a progress note of their own in the chart, or just co-sign the one already written by the resident.