When you watch medical drama on TV, like House M.D. (no, I don’t watch medical drama, for that will remind me of work, and that is not relaxing), you will see a team of doctors round and deliberate on each patient. That may not be necessarily true everywhere, but that is the case in academic hospitals.
I remember when I was a 4th year medical student in the Philippines at UST, when a senior attending physician make his rounds on teaching patients (patients that are managed by training physicians), he takes with him all the residents, interns and medical students on service. This can be 10-15 people (it’s a crowd) all in all.
In our culture, the attending physicians are treated like demigods, and some of them act like gods. They command fear in our hearts and strike terror, that we, mere mortals would shake and tremble in their presence. The residents would even assign us duties during this fanfare rounds. One student will be fanning the attending (it could be hot and humid in the charity wards), one student will be carrying the patient chart, an intern will be writing all the orders in the chart, and we then have to take turns on asking relevant questions (which were rehearsed!) to the attending. Of course we should be ready to answer his questions too or else we will get demerits!
Now that I am an attending physician in a teaching hospital here in the US, I am surrounded by an entourage too, when I make my rounds in the ICU. Though, I am far from being treated as a demigod, and I don’t want to be treated as one. My rounds are more relaxed and has more of a collegial atmosphere. I don’t give demerits. During my rounds, no one is shaking, except for maybe the patient whose having shaking chills from a fever.
During this month, my team includes 1 senior resident, 2 interns, 1 medical student, 1 pharmacist, 2 pharmacy students, and a respiratory therapist. Of course the nurses assigned to each individual patient will join us once we are in the room of a particular patient. Once in a while the nutritionist and the social worker will join us too.
It is nice to have all the support and expertise I can get from the team, so we will not miss anything. But it is my responsibility to keep the rounds running smoothly and efficiently, as it can be chaotic at times with a big group of people, and not to mention all the excitement going on at once in the ICU. I want to call it controlled chaos.
During weekends when we are on-call, we don’t have a big entourage when we make our rounds. I am all by my lonesome. Of course there is a resident on-call, a respiratory therapist and pharmacist available, they just don’t join me for rounds. It does not mean it takes me longer to see all the patients, in fact, sometimes I finished much faster. Go figure.