What prevented the attending physician
from being truthful with the hospice team about his plan to reduce Sal's feedings?
He will also look for errors or omissions on charts, failure to inform the attending physician
, chart entries made long after a particular incident occurred, and failure to update or follow the resident's care plan.
The attending physician
sees the latest blood culture and is not concerned, because the fever the day before has subsided and the two prior positive blood cultures were not seen--"out of sight, out of mind.
A house officer who brings a case may feel more obliged to follow committee opinion than would an attending physician
The group also looks at admissions, guidelines, practice patterns of attending physicians
and residents, operational efficiency, bed management and managed care.
Practices by the attending physician
staff that were never subject to management scrutiny before, such as reliance on the local emergency room at night and on weekends, standing orders for therapeutic diets, or care routines that are more rote than reasoned, may need to be reevaluated.
All Medicare certified hospices have medical directors to oversee the clinical components of care and who often assume the role as the hospice patient's attending physician
if the patient's regular physician feels this is appropriate.
It is up to the attending physician
to determine his or her degree of involvement.
The facility can assist the attending physician
by having the patient, the chart and any necessary test results, the equipment and appropriate assigned staff ready.
His credentials include a Doctor of Podiatric Medicine from the Temple School of Podiatric Medicine (1994); Chief Resident Cambridge Hospital; Tufts University Achievement of Excellence (2002); and Cambridge Residency Program Attending Physician
of the year (2003).
The encounter between the attending physician
and the medical director is compounded by the "physician personality," which is egocentered and individualistic.
If the attending physician
feels the physician executive is hesitant and uncertain, the physician executive has given up the high ground.
Although in our hospital the average length of stay has decreased over the past year through a variety of measures aimed at the attending physician
, it still remains unacceptably high.
For example, if a physician is having some difficulty with the management of a diabetic, the chief of medicine is notified, consultation with the attending physician
follows, and corrective action is taken before a more significant problem occurs.
David McCollum, noted GI Cancer Researcher and attending physician
at Baylor Sammons Cancer Center and US Oncology.