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 In a new study, gynecology patients receiving treatment at a
teaching hospital did not fully understand the differences between
an attending physician, a resident doctor and a medical student.
“Most patients don’t realize that in a teaching hospital, it’s the
residents that are doing the majority of the work,” Dr. Ronald Blatt,
Medical Director of the Manhattan Center for Vaginal Surgery in New
York City, told Reuters Health in a phone interview.
Dr. Catherine Flood of the University of Alberta and colleagues
surveyed 108 women awaiting major gynecological surgery. Questions
assessed patients’ knowledge of residents’ responsibilities as
compared with duties of medical students and attending physicians.
In addition, researchers measured patients’ comfort level with
resident doctors.
Most women - 83 percent - understood that residents “had a higher
level of training” than medical students, but only 60 percent
realized that a resident is actually a doctor, the authors report in
the Journal of Obstetrics and Gynaecology Canada.
That might explain why only 50 percent of respondents indicated that
they would feel comfortable with a resident operating on them, even
under the supervision of a practicing physician.
“Typically, patients are under the impression that (surgical)
residents merely assist in pre-and post-operative procedures when,
in reality, they are performing the actual surgery,” said Blatt, who
was not involved with the new study. “This, of course, is only when
the practicing physician is fully confident in the resident’s
capability. It’s actually one of the benefits of getting treatment
at a teaching hospital. There are more practitioners keeping a close
eye on things compared to non-teaching hospitals.”
Residents have graduated from medical school. They practice in
teaching hospitals or clinics under the direct or indirect
supervision of an attending physician for several years before
deciding on a sub-specialty. But it’s important to note that
“resident” can mean anything from a first-year intern who is just
out of medical school to a chief resident who is in his or her final
year of training.
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In this study, while 92 percent of the women surveyed believed in
the importance of knowing their doctor’s level of training, only 63
percent reported actually having such knowledge. Fifty-six percent
of those polled reported a desire to learn more about the role of
resident doctors.
“Considering the significant role of residents in patient care,
educating patients is essential to improve their comfort and the
overall consent process,” the authors write.
This study is the first of its kind in the gynecological discipline,
but there are a few limitations worth noting. The sample size was
small and comprised only of a region-specific Canadian cohort, which
limits the generalizability of the results.
To promote a better understanding among patients, the researchers
suggest “placing placards throughout teaching hospitals, handing out
pamphlets in waiting rooms, or reviewing consent forms in greater
depth in the office setting.”
Previous research, they note, shows that informed patients tend to
be more actively involved in their own care and have better health
outcomes than their uninformed counterparts.
“Considering the valuable role that residents play in patient care,
educating patients about their providers is essential to improve
their satisfaction, comfort, and the overall value of the consent
process,” the researchers conclude.
SOURCE: http://bit.ly/2i2wpsk Journal of Obstetrics and Gynaecology
Canada, online August 29, 2017.
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