Blog | Thursday, February 22, 2018

Tips for internal medicine attendings include making rounds a conversation


Recently I observed rounds someone else's rounds. During those rounds, interns or students reported to the attending physician who took notes. Interaction was minimal, and other members of the team totally ignored the interactions.

This week I realized that our rounds were conversations. We take cues from each other, and use these cues to improve understanding. We involved the entire team in decision making and learning. I teach some things, but the resident and intern also do some teaching. Everyone on the team understands what our plan is for each patient.

The secret is an ongoing conversation. Students feel comfortable asking questions. I feel comfortable asking the team to do a quick internet search, because I do not know all the answers. Often when I think I know, we still look up an answer to be safe. I hope this is important role modeling.

If you are an attending physician, do you engage the entire team in conversation? Do you have them help you when you are not 100% certain of a fact?

As I considered this framing of rounds this week, I wondered if writing these thoughts would help my colleagues. Often I just have thoughts that I think are exciting, but actually are not. If this helps you at all, please let me know.

db is the nickname for Robert M. Centor, MD, MACP. db stands both for Dr. Bob and da boss. He is an academic general internist at the University of Alabama School of Medicine, and the former Regional Dean for the Huntsville Regional Medical Campus of UASOM. He still makes inpatient rounds regularly at the Birmingham VA and Huntsville Hospital. His current titles are Professor-Emeritus and Chair-Emeritus of the ACP Board of Regents. This post originally appeared at his blog, db's Medical Rants.