Journal of General Internal Medicine

, Volume 23, Issue 5, pp 607–610

Patients Do not Know the Level of Training of Their Doctors Because Doctors Do not Tell Them

  • Sally A. Santen
  • Tricia S. Rotter
  • Robin R. Hemphill
Original Article

Summary

Setting

Although patients should know the level of training of the physician providing their care in teaching hospitals, many do not.

Objective

The objective of this study is to determine whether the manner by which physicians introduce themselves to patients is associated with patients’ misperception of the level of training of their physician.

Patients/Participants

This was an observational study of 100 patient–physician interactions in a teaching emergency department.

Measurements and Main Results

Residents introduced themselves as a doctor 82% of the time but identified themselves as a resident only 7% of the time. While attending physicians introduced themselves as a “doctor” 64% of the time, only 6% identified themselves as the supervising physician. Patients felt it was very important to know their physicians’ level of training, but most did not.

Conclusions

Physicians in our sample were rarely specific about their level of training and role in patient care when introducing themselves to patients. This lack of communication may contribute to patients’ lack of knowledge regarding who is caring for them in a teaching hospital.

KEY WORDS

physician–patient relations graduate medical education teaching hospitals 

References

  1. 1.
    The Council on Ethical and Judicial Affairs of the American Medical Association. Medical student’s involvement in patient care. J Clin Ethics. 2001;12:111–5.Google Scholar
  2. 2.
    The American College of Physicians. Ethics manual. Ann Intern Med. 1998;128:576–94.Google Scholar
  3. 3.
    Santen SA, Hemphill, Prough EE, Perlowski AA. Do patients understand their physicians’ level of training? A survey of emergency department patients. Acad Med. 2004;79:144–7.PubMedCrossRefGoogle Scholar
  4. 4.
    Hemphill RR, Santen SA, Rountree CB, Szmit AR. Patients’ understanding of the roles of interns, residents, and attending physicians in the emergency department. Acad Emerg Med. 1999;6:339–44.PubMedCrossRefGoogle Scholar
  5. 5.
    Joint Commission of Accreditation of Healthcare Organizations, Accreditation Manual for Hospitals. [monograph on line]. Oakbrook Terrace: Joint Commission Resource Inc.; 2002 [updated 2002 May 2, cited 2002 May 29]. Sections RI.1.2, MS 2.5 and 6.9.Google Scholar
  6. 6.
    Levinson W, Roter DL, Mullooly JP, Dull VT, Frankel RM. Physician–patient communication: the relationship with malpractice claims among primary care physicians and surgeons. JAMA. 1997;277:555–9.CrossRefGoogle Scholar
  7. 7.
    Smith RC, Lyles JS, Mettler MA, et al.. A strategy for improving patient satisfaction by the intensive training of residents in psychosocial medicine: a controlled, randomized study. Acad Med. 1995;70:729–32.PubMedCrossRefGoogle Scholar
  8. 8.
    Hall JA, Roter DL, Katz NR. Meta-analysis of correlates of provider behavior and medical encounters. Med Care. 1988;26:657–75.PubMedCrossRefGoogle Scholar
  9. 9.
    Wendler DS, Shah S. How can medical training and informed consent be reconciled with volume outcome data. J Clin Ethics. 2006;17:149–57.PubMedGoogle Scholar
  10. 10.
    Lo B. Resolving Ethical Dilemmas, A Guide for Clinicians. 2nd ed. Philadelphia, PA: Lippincott Williams and Wilkins; 2000:19–28.Google Scholar
  11. 11.
    Hafferty FW, Franks R. The hidden curriculum, ethics teaching, and the structure of medical education. Acad Med. 1994;69:861–71.PubMedCrossRefGoogle Scholar
  12. 12.
    Beatty ME, Lewis J. When students introduce themselves as doctors to patients. Acad Med. 1995;70:175–6.PubMedCrossRefGoogle Scholar
  13. 13.
    Santen SA, Hemphill RR, Spanier CM, Fletcher N. “Sorry, it’s my first time!” Will patients consent to medical students learning procedures. Med Educ. 2005;39:365–9.PubMedCrossRefGoogle Scholar
  14. 14.
    Williams CT, Fost N. Ethical considerations surrounding first time procedures: a study and analysis of patient attitudes toward spinal taps by students. Kennedy Inst Ethics J. 1992;2:217–31.PubMedGoogle Scholar
  15. 15.
    Santen SA, Hemphill RR, McDonald MF, Jo CO. Patient willingness to allow residents to learn to practice medical procedures. Acad Med. 2004;79:139–43.PubMedCrossRefGoogle Scholar

Copyright information

© Society of General Internal Medicine 2007

Authors and Affiliations

  • Sally A. Santen
    • 1
    • 4
  • Tricia S. Rotter
    • 2
    • 5
  • Robin R. Hemphill
    • 3
  1. 1.Department of Higher Education Leadership, Policy OrganizationVanderbilt Peabody CollegeNashvilleUSA
  2. 2.Department of Emergency MedicineBrown Medical SchoolProvidenceUSA
  3. 3.Healthcare Solutions GroupVanderbilt University Medical CenterNashvilleUSA
  4. 4.Office for Teaching and Learning in MedicineVanderbilt University School of MedicineNashvilleUSA
  5. 5.Kaiser Sunnyside HospitalClackamasUSA

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