Daniel Esgardo Rangel Barón: Tips for IM attendings – Chapter 21 – make 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.

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