Suffering from the worst headache of your life, you check into your community emergency room. Your neck hurts and you can’t seem to shake off the persistent feeling of nausea. You are rushed to the radiology department to get an urgent brain scan. Moments later, you are diagnosed with a brain bleed and the emergency physician wants to transfer you to a well known teaching hospital for definitive treatment.
But what is a teaching hospital and who will care for you when you arrive? A cadre of medical teams will see you and some will operate on you. Some of these young eager doctors are learning the art of surgery and medical care for the first time. You might even have a surgical trainee operate on your brain. What would you ask if you knew that it was his first time operating on the brain? Each year at teaching hospitals, 100,000 physicians in-training are learning how to operate and care for patients under such circumstances. Imagine knowing what questions to ask and how to determine if your physician is adequately prepared to tackle your surgery.
Why focus on teaching hospitals? According to the American Association of Medical Colleges, teaching hospitals account for 20 percent of America's hospitals. The country's 1100 teaching hospitals provide a wide variety of services critical to the nation's health care delivery system. Teaching hospitals conduct two-thirds of all highly specialized surgeries, treat nearly half of all patients with highly specialized diagnoses and, on average, handle more than 30,000 emergency room visits per hospital a year.
Take it from an Intern: Medical Advice from a Brain Surgeon explores the interactions between patients and their doctors, with particular attention to physicians in-training. I use the experience of my internship in surgery to elucidate common medical errors at teaching hospitals and to depict situations where patient care is compromised. I discuss the hierarchy of academic medical centers and provide valuable insight for patients to obtain the best care and outcome. Each chapter is based on a medical error or dilemma presented in the context of a narrative clinical vignette. The discussion of the problem aims to educate patients about the limitations of teaching hospitals and will empower them to demand more from their doctors.
