Are residents net producers for society?

[PostLessOne]

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I've seen posts on these forums where attendings and program directors complain that having residents doesn't make them any more money. Medicare/insurance won't pay up if a resident does something and tries to bill for it, and so forth. Some of the surgeons complain that a resident just slows them down.

So, this makes me wonder. Ignoring the dollars and cents element, is a resident physician overall producing more wealth for society than he or she is consuming? On the one hand, said physician works his/her ass off trying to treat patients for 60-80 hours a week. He/she has an M.D., and is supposed to rapidly gain proficiency and skill. I've seen clinics where the residents do a good chunk of the work, and attendings are nowhere to be seen. On the other hand, a resident is more likely to make errors that will cost a patient, and requires babysitting and handholding and training from attending physicians who would otherwise be treating more patients.

What does it equate out to in the end, if you ignore artificial elements like the 100k the government gives each hospital for having a resident and the millions of dollars in public funds most nonprofit hospitals receive every year?

Also, do most physicians consider residency as part of their working career when they estimate their years of experience?

 

[nirvana23]

I would like to see our attendings admit 25 patients in a night or see 40+ clinic patient in one day. It is one thing to do things yourself, quit another to addend a note saying "Agree with the resident's note above."

 

[Apollyon]

I would like to see our attendings admit 25 patients in a night or see 40+ clinic patient in one day. It is one thing to do things yourself, quit another to addend a note saying "Agree with the resident's note above."

In the ED, the attending without residents will outdo residents the vast majority of the time. A colleague of mine saw 42 patients in 12 hours on one shift. An academic attending saw 50 on a 12 hour shift, with 4 residents.

 

[nirvana23]

I was speaking about internal medicine. ED is a different order of magnitude as far as numbers. Our ED can go through 250+ patients in 24 hours... whole different ballgame.

 

[MattinglyMD]

You raise some very cogent questions. As an attending for more than 20 years at a federal/state/city-funded hospital, I've seen the residents contribute economically to both the hospital and the departmental budgets and service a spectrum of patient populations. I would imagine it's very difficult to parse out the NET monetary effect given the variables mentioned above as well as the dimensional financial complexities inherent in delivering health care that would challenge a Cray computer. One thing is certain: A significant segment of the population would absolutely be denied health care without residents' tireless, stalwart, noble efforts.