Do all patients know what an intern/resident/attending is?

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europeanIMG

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Hi,

Do all American patients know what it means to be an an intern, resident or attending?

Do you present yourself like "Hello I am dr. EuropeanIMG, I am an intern in internal medicine/surgery etc?" or do you say that you are a junior doctor or something else?

When you´ve seen a patient, do you tell the patient that you will discuss with your attending and get back to him/her later or do you say superior/supervisor or something else?

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Hi,

Do all American patients know what it means to be an an intern, resident or attending?

Do you present yourself like "Hello I am dr. EuropeanIMG, I am an intern in internal medicine/surgery etc?" or do you say that you are a junior doctor or something else?

When you´ve seen a patient, do you tell the patient that you will discuss with your attending and get back to him/her later or do you say superior/supervisor or something else?

Most patients don't know the difference b/w intern, senior resident, attending.
I usually say " I am Dr. XYZ, I'm on Dr. ABC's team"....that let's them know who the boss is so when Qs come up that I need to ask the attending they understand.
 
Hi,

Do all American patients know what it means to be an an intern, resident or attending?

Do you present yourself like "Hello I am dr. EuropeanIMG, I am an intern in internal medicine/surgery etc?" or do you say that you are a junior doctor or something else?

When you´ve seen a patient, do you tell the patient that you will discuss with your attending and get back to him/her later or do you say superior/supervisor or something else?

I find that most patients do not know what the difference between these things are. A lot of times the MD/PA will leave the room and the patient asks me who that was. They do not know that an intern means a first year resident. You can be a 5th year surgical resident/fellow or a med student and they will still refer to you as an intern. I do not introduce residents as student doctors or junior doctors. If the patient asks me what a resident is, I tell them that they graduated medical school and are training closely with senior doctors in a specialty area. I found that is the best explaination I could give them that makes them feel confident that they are being cared for by highly educated and trained professionals. If the patient voices that they only want to see thier private MD or attending, I tell them that these doctors are in communication with Dr. Attending while he/she is in a case or is not in the hospital. After this type of dialogue with the patient, I personally have never had a patient refuse to be seen by a resident.

The residents I work with handle this different ways. If the patient knows the attending MD, they introduce themself as "Dr. Resident, the resident working with Dr. Attending". If the resident is consulting from a different service, they introduce themself as Dr. Resident from the department of surgery/GI/whatever. Patients often freak when they hear "surgery" because some will automatically think if they are being seen by a surgeon that they are getting surgery.
 
From my experience, people don't really know who everyone is. Patients and family members are under a lot of stress, and it is difficult to cope with all the moving pieces of a healthcare team.

I think how it is explained depends a lot on the hospital and the training environment. There are some big academic hospitals where the residents really run the show, and the attendings tend to lay back a bit. There are other private hospitals where the situation is exactly the opposite.

When I was a senior resident at a big academic place, I usually gave the patients and families "the lay of the land" when I met them, and told them that the junior resident was their primary MD, and their point person for everything. That keeps the junior in the loop as much as possible. I would tell them that I was the junior's boss, and that the attending was my boss. I always mentioned that the attending was their "official doctor" and that they were ultimately responsible for the entire chain of command.

As an aside, from a legal standpoint it is critical that the patient and family understand the position and level of training for the physicians on the healthcare team. In a lawsuit, it is a bad thing if patients and family members are given the impression that the junior resident is a fully trained expert in their field.

By the way, this is from a medical (neurology) perspective, rather than surgical. Surgical services tend to be much more attending-centric, akin to the above post of "I'm Dr. XYZ, I'm on Dr. ABC's team".
 
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They dont have a clue for the most part....

Just say you are Dr. _ and let med students say who they are.

And frequently introductions don't clear things up for them.

Plus there are gender complications. As a female, I can't tell you how many times I introduced myself as Dr X, and the pt didn't hear it- if you are female, you are a nurse. And if you are male medical student, you are the doctor. Pts have been known to complain they haven' t been seen by a doctor when the most senior MD on the team is a female.
 
And frequently introductions don't clear things up for them.

...Pts have been known to complain they haven' t been seen by a doctor when the most senior MD on the team is a female.

LOL I've seen this happen too!
 
Hi,

Do all American patients know what it means to be an an intern, resident or attending?

I think that if you eliminated patients who were in the medical field themselves, less than 1% of patients could accurately describe the difference between intern, resident, and attending.
 
LOL I've seen this happen too!

I even had it happen in the Trauma Bay with a new nurse - she questioned the male 3rd year medical student about my order, as Chief Trauma Resident, to set up the Level 1 infuser. Not just patients with those biases.

I laugh about it now...a few months ago I had an 86 yo patient that just couldn't get over that her surgeon was female. "Oh honey, that is so wonderful". She apparently told all of her old lady friends about her "lady doctor" and wasn't it nice that they let girls into medical school these days.:laugh:
 
rofl, patients? Try the chairperson of the department didn't know who
one of his own first year residents was. I was going into a patient
room, heard him walking down the hall, along came one of our first
years (mind you, there are only 3/year in this program). He
looks at her and asks, "excuse me, are you one of the nurses? can you
tell me what room Mrs So and So is in?" She looked at him incredulously
and said "Dr.So and So, I am Sue Jones, one of YOUR residents". He
just brushed that off and said "but do you know what room my patient
is in?" Yikes :eek:
 
rofl, patients? Try the chairperson of the department didn't know who
one of his own first year residents was. I was going into a patient
room, heard him walking down the hall, along came one of our first
years (mind you, there are only 3/year in this program). He
looks at her and asks, "excuse me, are you one of the nurses? can you
tell me what room Mrs So and So is in?" She looked at him incredulously
and said "Dr.So and So, I am Sue Jones, one of YOUR residents". He
just brushed that off and said "but do you know what room my patient
is in?" Yikes :eek:

:laugh:

We had something similar happen once.

I was meandering down the hallway on the surgical floor with the Dept Chair when he commented about one of the "male techs" and his rather impressive biceps (not in a sexual way, just "wow he must work out a lot, guess you can do that when you are aren't a doctor").

I said, "Sir that's one of our Prelim interns, going into Ortho next year."

Dept Chair: <embarassed laugh> "oh well, you must not be working him hard enough if he has that much time to exercise. You better tell him he shouldn't expect to keep that up."

Me: "yes sir." :rolleyes:

(to be fair, we had about 20 interns per year, but I still thought it was funny)
 
the answer is NO.

to make it more simple, Im doing endocrine elective. I round with a fellow and the attending. Today the three of us went into a room to see a pt and the son of the patient asked us "are you all three doctors". they dont even know if we are doctors let alone what rank we have.
 
My experience is that they've heard the words "intern, resident, etc", but don't know what they mean.
 
I think many people think hospitals are similar to the shows they watch on TV. I liked St Elsewhere but none since so not sure how current shows portray doctors.

To be honest when I started work as a graduate nurse I did not know the difference between a resident and an attending because the two hospitals where I did my clinicals did not have residents.
 
To be honest when I started work as a graduate nurse I did not know the difference between a resident and an attending because the two hospitals where I did my clinicals did not have residents.

I didn't really understand the hierarchy until my 3rd year of medical school. How on earth could I expect patients to know the differences?

As a medical student, I would introduce myself as "My name is (my first name). I'm the medical student who works in the Emergency department/on the medicine/surgery/OB/consult/etc. team. My BOSS is Dr. so-and-so (I would NEVER use the word "attending" because most people have no idea what this means). Our TEAM will be taking care of you/taking you to surgery/helping you to deliver your baby/giving recommendations to your primary team/etc." I feel like most patients understood this approach and had confidence that they were being cared for by a large number of people, headed by an "expert" or "boss" in a particular field. Also, I think patients felt comfortable being talked to/examined/advised by a medical student because I identified my boss up front, and made it clear that anything we decide to do is done as a team with my boss's input and final say.

I plan to continue using this approach as a resident; however, I will introduce myself as "Dr. Wolverine." I will still make it clear that, after I see the patient, that "I will confer with my boss, one of the head doctors in the Emergency Department/ICU/trauma team/etc., and we'll come up with a plan for you."
 
I did the same as Lady W.

My own family doesn't know the difference btwn intern/resident/fellow ("what's this fellowship thing?" Admittedly, they are very medically naive.) and attending.

Everyone understands the word boss and if you refer to the attending as "the boss", most patients get that.
 
Hi,

Do all American patients know what it means to be an an intern, resident or attending?

Do you present yourself like "Hello I am dr. EuropeanIMG, I am an intern in internal medicine/surgery etc?" or do you say that you are a junior doctor or something else?

When you´ve seen a patient, do you tell the patient that you will discuss with your attending and get back to him/her later or do you say superior/supervisor or something else?


I found that often I lost patients when I said I was a fellow. That to them meant I was just a jokester of a street (some nice fellow they found to join rounds) and they still looked to the resident or intern for what the plan was.
 
I found that often I lost patients when I said I was a fellow. That to them meant I was just a jokester of a street (some nice fellow they found to join rounds) and they still looked to the resident or intern for what the plan was.

:laugh::laugh:

I agree the term "fellow" is probably the most confusing to patients. The fellows I work with usually just introduce themselves as Dr. Soandso from critical care/gi/neph/whatever and the patients don't ask many questions after that. Patients like being seen by a specialist.

Even if the patients don't know what these terms mean, they almost always understand what MD and RN mean so if the person has MD on their ID, the patients know they are seeing a physician. I will go out on a limb and say for the most part, patients care the most about knowing who is the MD and who is the RN assigned to them. Everyone else just seems to fall right in the middle somewhere.
 
Most patients don't know jack...they just want to know who is their nurse @the time and which doctor is in charge and/or going to be approving their meds. Few of them know much about the hierarchy in a teaching hospital.
 
Most patients don't know jack....


Truly


I had a couple of patients apologize for waking me up when they used their call lights on the night shift. Not sure which medical show/soap opera they had seen that had sleeping night shift nurses. :confused:
 
Truly


I had a couple of patients apologize for waking me up when they used their call lights on the night shift. Not sure which medical show/soap opera they had seen that had sleeping night shift nurses. :confused:

:laugh::laugh::laugh::laugh::laugh:

If we get a break we are lucky, nevermind a nap!!!
 
I, too, used to refer to the attending as The Boss.

It's useful to remember that the general public is pretty clueless when it comes to medical matters. Shows like Grey's Anatomy don't help. And this is why it is so easy for nurses to pretend to be doctors- when patients don't understand the roles, this confusion can be taken advantage of.

The other female posters reminded me that, when I was an intern, i was rounding post call on trauma, dressed in scrubs with my resident white coat, and one of the plastic surgery attendings approached me with a question thinking I was a nurse. Now, granted, it was early in the year and i hadn't done my plastics rotation yet, but still...I was dressed like all the other residents, not like a nurse. When I informed him I was the trauma intern he did apologize and seem a little embarrassed. The female medical student with me shot him a look that could kill. She was livid- I think that was the first time she witnessed that sort of behavior.
 
-I don't think the general public is "clueless" and it is insulting to infer so.

-If more people would introduce themselves when they meet patients, some of the confusion would come to an end.

-However, having said that, I always introduce myself as "registered nurse" but patients always refer to me as "the doctor." Some do some don't. You can't force people to listen.

-I don't think patients really care about the difference between intern resident attending, nurse practitioner, etc. They just want things taken care of in a cordial, efficient and timely manner and that the person who helps them takes the time to listen to them and answer their questions.
 
I agree-- the public is not misinformed. It's just jargon. Can you fault a layperson for not knowing that an "MI" is a heart attack or "appreciate" means "noticed?"

I actually think "intern" is the worst & most confusing term. Everyone else in the world a "intern" is someone very young without enough experience or knowledge to even get paid. Or Monica Lewinsky. Would you want an "intern" (college sophomore working 20 hours a week for a line on his CV) within a 20 foot radius when discussing your care? I prefer saying "first year resident" (to the more savvy; the less savvy get "one of the surgery doctors") instead.

And I always call the attending the "boss doctor."
 
I even had it happen in the Trauma Bay with a new nurse - she questioned the male 3rd year medical student about my order, as Chief Trauma Resident, to set up the Level 1 infuser. Not just patients with those biases.

I laugh about it now...a few months ago I had an 86 yo patient that just couldn't get over that her surgeon was female. "Oh honey, that is so wonderful". She apparently told all of her old lady friends about her "lady doctor" and wasn't it nice that they let girls into medical school these days.:laugh:

I guess I am also guilty of this because I always thought you were a guy.
 
-I don't think the general public is "clueless" and it is insulting to infer so.

Fine, would you prefer "uninformed"? That's true and hardly insulting. The average person doesn't know the different levels of medical training.

-If more people would introduce themselves when they meet patients, some of the confusion would come to an end.

-However, having said that, I always introduce myself as "registered nurse" but patients always refer to me as "the doctor." Some do some don't. You can't force people to listen.

No one is saying we shouldn't introduce ourselves to our patients. Where is all of your hostility coming from and why can't you drop this when someone (lately me) gives you the answer.

-I don't think patients really care about the difference between intern resident attending, nurse practitioner, etc. They just want things taken care of in a cordial, efficient and timely manner and that the person who helps them takes the time to listen to them and answer their questions.

As you said above, some do and some don't. That's why everyone should introduce themselves (as above). If the patient is confused about your title, you should explain it.

NB: Saying you're "just like a doctor" when asking what an NP is doesn't fly. Sorry.
 
-I don't think the general public is "clueless" and it is insulting to infer so.

There are a lot of people who go beyond misinformed. They are indeed clueless. Maybe the institution you are working is different. Patients i encounter- many don't know, and don't want to learn. They just want their demands met right now. I believe in calling a spade a spade and not dancing around the truth with politically correct BS.

[/QUOTE]-If more people would introduce themselves when they meet patients, some of the confusion would come to an end.[/QUOTE]

Maybe, maybe not. Again, I have encountered a lot of people who don't care to learn. They don't care to learn what their medical problems are. They don't care to write down their medications. They don't care to learn how to take better care of themselves.

[/QUOTE]-However, having said that, I always introduce myself as "registered nurse" but patients always refer to me as "the doctor." Some do some don't. You can't force people to listen.[/QUOTE]

And if they won't listen, how explaining to it ever end the confusion? Do you constantly correct them when they refer to you as a doctor?
 
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