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Considerations for Attending Rounds

Paul Bergl, MD1; Vineet Arora, MD, MA2; Jeanne Farnan, MD, MHPE3
[+] Author Affiliations
1Internal Medicine Residency, Department of Medicine, University of Chicago Pritzker School of Medicine, Chicago, Illinois
2Section of General Internal Medicine, University of Chicago Pritzker School of Medicine, Chicago, Illinois
3Section of Hospital Medicine, University of Chicago Pritzker School of Medicine, Chicago, Illinois
JAMA Intern Med. 2014;174(1):161-162. doi:10.1001/jamainternmed.2013.11122.
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To the Editor We would like to commend Stickrath et al1 on their study affirming that contemporary attending rounds entail far too many service-oriented tasks without sufficient educational time. This article also exposes a particularly alarming trend in medicine today: the dearth of bedside teaching of physical diagnosis.

Stickrath et al1 found that attending physicians taught physical examination on only 14% of rounds. Another recent study found that medicine residents spent only 12% of their time in direct patient care.2 These studies together highlight a lack of patient contact and dedicated teaching time that stems from the myriad competing priorities on inpatient medicine services. The complexity and acuity of inpatient care, resident work hour restrictions, and the focuses on quality, timely documentation, and discharge seemingly have made bedside teaching an afterthought. Despite these other priorities, an attending physician’s demonstration of the examination merits a prominent and permanent place on rounds.

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January 1, 2014
Chad Stickrath, MD; Mel Anderson, MD
1Department of Medicine, University of Colorado Denver School of Medicine, Denver2Medical Service, Denver Veterans Affairs Medical Center, Denver, Colorado
JAMA Intern Med. 2014;174(1):162. doi:10.1001/jamainternmed.2013.11085.
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