• The Hospital Team

    The Hospital Team

    • Your hospital team numbers much more than the admitting surgeon, internist, or pediatrician.
    • The floor you are admitted to is often referred to as a unit.
    • In a teaching hospital you will have, in order of seniority, interns, residents and fellows who will follow patients on more than one unit.
    • These physicians-in-training belong to a single service or team and will “follow” patients on many units.
    • Your unit care givers include, for example, the nurses and nurses aides, and physical therapists, and technologists
    • The unit support staff includes the unit dieticians, secretaries, transportation aides, and housekeeping

    The hospital team is made up of your attending, consultants, the house officers (interns and residents), nurses and physician assistants that participate in your care.

    Will medical students be treating me?

    The medical students you will encounter in the hospital are 3rd and 4th year students who are finishing up medical school. Their first two years are spent primarily in the classroom. It is in the last two years that medical students acquire the clinical knowledge and experience necessary to earn a medical degree. One positive attribute that medical students bring to hospitals is their enthusiasm, willingness to work, and the most up-to-date knowledge of basic aspects of medicine.

    What does an “intern” do in a hospital?

    After students graduate from med school, they become first year doctors or interns. A new crop of interns descends upon hospitals each July. This is the recent students’ chance to show how much they have learned and put that knowledge into practical use. Interns are expected to closely monitor all assigned patients and do the “scut” work—those mundane but necessary items that are considered less interesting to more experienced physicians. These tasks include drawing blood, writing daily patient notes, starting IV’s, and checking labs to name a few. While these doctors are new to medicine, they have some practical experience and are a valuable resource for attendings and the rest of the house staff.

    When does an intern become a resident?

    Residents are those young doctors who have completed one year of internship, but haven’t yet completed all requirements for their specialty. The years of residency will vary according to the field they choose to pursue. Some are as short as two years, while others may be as long as four. There is a hierarchical progression through residency just as there is in the military.  Senior residents supervise the less experienced residents and the interns, and have significant responsibility regarding treatment decisions.

    Fellow is more than just a synonym for “guy.”

    A doctor who has completed their internship and fulfilled residency requirements may decide to further pursue a subspecialty area. Doctors in this phase of their post-doctoral training are called fellows, and their position is referred to as a “fellowship.”

    Who is the most senior doctor in the staff?

    The most senior medical staff is composed of the attendings. These are licensed physicians with privileges at the hospital. Attendings are discussed in more detail in the “Senior Physicians” section of this website.

    Who else directly contributes to my treatment?

    Besides doctors and nurses, the two other major categories of clinical or medical professionals in the hospital are therapists and pharmacists. Therapists include respiratory, occupational and physical therapists. They may work to improve fine motor function after a surgery or other debilitating event, such as a stroke. Respiratory therapists are credentialed to help patients maintain breathing capacity, although they do not have a medical or nursing degree.

    Pharmacists are probably the most important people who participate in patient care without frequently interacting with patients themselves. They are responsible for maintaining all patients’ medications while checking for drug allergies and drug interactions that could adversely affect the patient. Most hospital pharmacy programs now require a pharmacist to attend school for six years, after which they obtain a doctorate in pharmacy.

    As capable as most pharmacists are, it is very important to be aware of your normal medications and their dosages. No matter how many sets of eyes may look over your medications before they are delivered to you, doctors, nurses and pharmacists are all human, and mistakes can happen.

    What is the Quality Assurance Team?

    Each hospital will have a Quality Assurance Team comprising doctors from various specialties—often the department chairs—and representatives of the nursing staff. The Quality Assurance team works to improve overall quality of care and safety for patients, visitors and staff.

    Quality Assurance will review hospital protocol, and investigate all accidents or breaches of protocol that may occur. They determine the cause of the accident or breach, and recommend changes in protocol or retraining of individual staff to ensure that patient care and safety is not threatened in the same manner again.


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