Navigating the health care system was second nature to Susan Harkema, who has worked as a consultant in the field for more than 20 years. That was until her first husband was hospitalized for a blood clotting disease. It was then that she saw a different side of health care — one crowded with white coats and confusion about who was overseeing her husband’s care.
When a friend or family member is admitted to the hospital, you can feel like you’re drowning. There are important decisions to make, and caregivers are often inundated with information. That’s why it’s important to stay on top of who’s who on the medical team, Harkema, 44, of Pittsburgh, says.
“I became his advocate, and for anyone facing a new disease, you feel overwhelmed because you don’t understand what the disease is, and now you’re sort of thrown into this whole new world of health care or hospital and it’s hard to get your bearing,” says Harkema, who writes as a patient advocate for My Health Voice, a website offering health care information for patients and providers.
This can be especially true at teaching hospitals, explains Dr. Janis M. Orlowski, chief health care officer at the Association of American Medical Colleges, which, in addition to patient care, provides clinical education and hands-on training to future and current physicians, nurses and other health professionals.
Hospitals are made up of various teams of medical specialties, from physicians who deal with cancer to cardiology. There are also treatment and testing teams that perform ultrasounds, respiratory screenings or collect blood work, for example.
In a typical teaching hospital, you may encounter a number of medical students, interns, residents and an attending physician. Orlowski says there is a meeting each morning, in which the attending physician gives instructions to the rest of the medical team. In essence, if an intern says you’re being discharged, he or she did not come to that conclusion on his or her own. That’s how teaching programs work, Orlowski says. “The interns aren’t independently deciding what is to be done. They’re doing things by indirect or direct supervision of the attending,” she adds.
But don’t hesitate to ask questions if the roles confuse you. If you’re the caregiver for an older patient and can’t be at the hospital to walk him or her through what is going on, make a list, Harkema suggests. Not long after her husband passed away in 2008, her 82-year-old father had a serious stroke and she once again assumed the role of caregiver. Because she couldn’t be in the hospital 24/7 with her dad, Harkema drew a chart of boxes on a piece of paper so he could understand which doctor was in charge of what part of his care.
If you’re the patient, it’s always good to have an advocate with you when you go to the hospital — whether it’s a relative, friend, neighbor or somebody from your church or community. Consider having someone ask questions and write down the answers in case you’re overwhelmed, Harkema says.
Still confused about who’s who? Here’s a breakdown of the chain of command to know who’s taking care of you at a teaching hospital:
Medical students. Although medical students are not yet physicians, Orlowski says they may still meet with a patient and conduct an examination with permission under the direct supervision of an attending physician.
By the time a medical student greets you in the hospital, he or she will have completed four years at a college or university to earn a bachelor’s degree with a strong emphasis on basic sciences, in addition to four years of education at a medical school accredited by the Liaison Committee on Medical Education.
Once med students have completed these requirements, they’re considered interns, or doctors who have graduated from medical school and are in their first year of a residency training program.
Residents. The graduate then enters what’s called a residency program, which can involve three to seven or more professional years of training under the supervision of a senior physician educator, according to the American Medical Association.
“The fact that it’s a teaching hospital is a good thing, because you’ll be getting extra attention and care,” says Dr. Alaukik Bhasin, a second-year psychiatry resident at Kennedy University Hospital in Sewell, New Jersey. “The intern has recently completed medical school and is very fresh in different areas of medicine.”
The amount of training time depends on whether a doctor is aiming to work in family practice, internal medicine, pediatrics or general surgery.
“The new guys are actually scared and going to put more effort into your care because they’ll want to cover every single aspect,” Bhasin says, adding that they may be far more thorough than their attending physician requests.
Attending physician. The buck stops here. This is the doctor who has completed medical training and is in charge of your overall care during your hospital stay. He or she will oversee the team of medical students, residents, nurses and other medical staff.
“It’s good to get the attending physician’s name, understand what specialty they’re from, get their contact information and know the best way to get a hold of them,” Harkema says.
If you’re not sure who’s the attending physician because of the constant flow of medical staff, ask your nurse, Harkema adds. “They know which doctors are easier to talk to and which aren’t.”
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Who’s Caring for You in the Hospital? originally appeared on usnews.com
Correction 08/25/15: A previous version of this article misattributed a quote to the incorrect source.
