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On Being a Doctor |

Attending Rounds

George A. Sarosi, MD
[+] Article and Author Information

From University of Minnesota, Minneapolis, MN 55417.


Requests for Single Reprints: George A. Sarosi, MD, University of Minnesota, Minneapolis Veterans Affairs Medical Center, One Veterans Drive, Minneapolis, MN 55417; e-mail, george.sarosi2@va.gov.


Ann Intern Med. 2010;153(7):482. doi:10.7326/0003-4819-153-7-201010050-00016
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The author describes how attending rounds have changed over the past 45 years.

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Attending Rounds in the New Era: Same Purpose, Different Style
Posted on November 3, 2010
Chad R. Stickrath
Denver VA Medical Center
Conflict of Interest: None Declared

We read with interest the commentary about "Attending Rounds" by Dr. Sarosi (1) in the October edition of The Annals of Internal Medicine, in which he elegantly and humorously compared his experiences on attending rounds as a medical student in 1963 with his experience as an attending in 2010. Dr. Sarosi recollects rounds in 1963 to have occurred in the presence of numerous trainees with well-rehearsed, memorized presentations, complete with laboratory specimens and diagnostic studies tucked into the charts. He contrasts this with a current rounding team consisting of disconnected and missing trainees rounding in an oft- interrupted manner where he feels pressured to deliver careful teaching to his sensitive trainees. Ultimately, Dr. Sarosi is left to complete attending rounds alone.

Clearly, the format of attending rounds has changed, constrained by work-hours, throughput pressures, and other regulatory issues. The purpose, however, remains the same: to concurrently provide excellent patient care and trainee education. Furthermore, it is our experience that when performed well, attending rounds (especially with a significant bedside component) can still provide the most efficient and efficacious way to care for patients, assess and teach trainees, and interact with families and staff.

While we too find ourselves without a completely full cadre of trainees at all times, preliminary data from a current study underway at our institution show that a senior resident and at least one intern and one student are all present on rounds 75% of the time and that teaching and feedback of some kind are occurring during the majority of rounding days.

We are hopeful that recent studies (2,3) combined with our forthcoming data about the detailed characteristics of attending rounds and associated attitudes and perceptions of rounding participants may lead to the development of a model for attending rounds which optimizes patient care, education, and satisfaction for all involved.

References

1. Sarosi GA. Attending rounds. Ann Intern Med 2010;153:482.

2. Priest JR, Bereknyei S, Hooper K, Braddock CH. Relationships of the location and content of rounds to specialty, institution, patient- census, and team size. PLOS 2010;5(6):e11246.

3. Crumlish CM, Yialamas MA, McMahon GT. Quantification of bedside teaching by an academic hospitalist group. Journal of Hospital Med. 2009;4:304-307.

Conflict of Interest:

None declared

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