I’m very excited to begin this 30-day journey with you Teaching Hospital and Students
Why are teaching hospitals important?
Preparing for future challenges requires a collective effort. The work of the nation’s medical schools and teaching hospitals is indispensable to the country’s overall health — and with strong federal support of their efforts to address the doctor shortage, sustain vital medical services, and develop better treatments for serious illnesses, the nation will be healthier, stronger, more competitive, and better prepared for whatever challenges lie ahead.
What determines a teaching hospital?
A teaching hospital, or academic medical center, is a hospital that partners with medical and nursing schools, education programs, and research centers to improve health care through learning and research.
Teaching hospitals are commonly linked with medical schools, but they do not award medical degrees. As of May 2023, our HospitalView database currently monitors more than 220 hospitals that are categorized as AMC and over 1,300 that are recognized as teaching hospitals. There are 192 hospitals that are considered to be both. If you are unsure if a hospital that you are using or a loved one is in fits this criteria, the information is available on the internet at: https://www.healthguideusa.org/teaching_hospitals.htm
Are teaching hospitals cheaper than non-teaching hospitals?
Believe it or not, except for medicare reimbursement for routine care, Teaching hospitals are generally considered to be more expensive than non-teaching hospitals, and some insurers and policymakers have advocated shifting care away from these institutions to lower healthcare spending for patients. Total costs of care are similar or somewhat lower among teaching hospitals compared to non-teaching hospitals among Medicare beneficiaries treated for common medical and surgical conditions, according to a new study led by researchers from Harvard T.H. Chan School of Public Health and Beth Israel Deaconess Medical Center. JAMA, 2017. If I were to guess, the reason why medicare reimbursement is the same or lower may be because of fixed cost agreements based on government payment schedules.
What if I am uncomfortable with a student(s) or I’m too sick to deal with the education process
Although many of the best hospitals in the United States are teaching hospitals, it is important to understand your rights as a patient. If you are not aware that you are in a teaching facility, you will soon notice many younger individuals following doctors during rounds in both inpatient and outpatient settings. This can sometimes include up to 10 people.
Both of my parents were in teaching hospitals, and 80 percent of the time, there were no problems, but when mistakes happened, we made the decision to no longer allow students to observe/treat. Life Lesson: One example was when my mom was very sick and admitted to a cardiology floor. It was late at night, and a student came in and asked her about her healthcare proxy and advance directives. I was there at her bedside. She told the student that “if there was no hope, she wanted nothing.” After she said that, he got up, took his clipboard, and exited her room. I told her, “Ma, you just told him that if you have a cardiac arrest tonight, you don’t want to be saved.” My mom was tired, not feeling well, and also on sedating medications and disagreed. I went to the front desk and asked the student to return to her room and reiterate what he heard as my mom’s advance directive wishes, and he said, “Nothing, no resuscitation, no code.” He interpreted it wrong BUT also did not probe and confirm and made a dangerous assumption. What she meant to say was that if she were terminal, she did not want to be on life-preserving machines or a feeding tube. That was a stark difference from what the student put in her medical chart.
What are my rights for care in teaching hospitals?
First and foremost, students need to inform patients that they are students. It is also the doctor's obligation to inform you and ask for your permission to allow students to participate in your care and get your approval. if you want to confirm or are uncomfortable because you may have many people at your bedside who do not seem to have a role except observing, please – ASK.
Patients have the right to refuse to allow medical students to participate in their care. You can refuse at any time. If you want to go a step further and ensure that everyone gets the message, you can put a sign on the door.
Pros and Cons of Having Students as Patients
There are both advantages and disadvantages to having medical students involved in your care. In some cases, doctors or specialists may take extra time with your case to ensure that everyone understands the lesson being taught. This may result in more careful and thoughtful explanations, treatment options, and better patient outcomes. On the other hand, having students present during consultations may make some patients feel uncomfortable. Have you ever watched a sick goldfish floating in a bowl? That is what it can be like, except it is you that is the goldfish. That being said, in my experiences, I have met some exceptional and considerate students but have also seen and been the victim of lack of experience, limited knowledge, and limited skill set in bedside manner.
Did You Know?
A new study led by researcher-clinicians at Harvard Medical School and Beth Israel Deaconess Medical Center suggests that the presence of academic medical centers within a healthcare market is linked to better outcomes for patients treated at nearby community hospitals.
Findings published on Feb. 1 in JAMA Network Open show that receiving care at a community hospital in a market with AMC presence was associated with lower mortality and a greater number of healthy days at home. These associations were greatest in markets with the highest AMC presence, indicating that AMCs may have a positive impact on outcomes for patients treated at neighboring community hospitals.