Thursday, June 12, 2025

When to Be In a Hospital

I'm not in a hospital.

C gave me fascinating instruction in when to be there, though. 

First, teaching hospitals generally provide better care, because there is a team of doctors for each patient instead of an individual. This isn't a hard and fast rule, but a general guideline.

In a teaching hospital, there's a hierarchy: 
Attending physicians (fully licensed physicians)
Senior Residents
Residents (first year out of medical school)
Medical students (if any)

In a hospital, the residents do pre-rounds very early, followed by revisiting those patients later with a senior resident (who can point out any possible omissions by the resident). The attending physician might also attend rounds or choose to have "conference room" rounds (where the patient isn't present but all the data is reviewed).

The annual transition for these tiers usually occurs on July 1 (not everywhere, but generally). This means that if you go for an elective procedure in May, for example, everyone has been in their role for almost a year (sometimes longer). The team has also been working together for almost a year.

If you go in July, the resident is new. The senior resident was often a resident last month. The attending physician could be in his first month (though not necessarily). It's a new team that has only worked together for a few weeks. 

At a non-teaching hospital--generally--the tiers are as follows:
Attending physician
Physician assistant
Nurse

C said nurses would be highly offended by those tiers because they see it as a team-based approach.

You can see the level of expertise in a non-teaching hospital is generally lower. It's not always true, but it's a good rule of thumb. 

So if you need surgery and it's not time-sensitive, go in May or early June to a teaching hospital for the best care. 




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