Background:
Patients admitted to academic teaching hospitals are often cared for by multiple physicians of different training levels. This study aimed to ascertain the ability of patients to identify their inpatient physicians and patient and system factors that predict patient ability to identify inpatient physicians.
Methods:
All general medicine inpatients at a single academic medical center were approached for an interview between July 2005 and April 2006. During the interview, they were asked standard demographic questions (race, ethnicity, education, age, etc.). Patients were also asked to name the doctors or trainees on the general medicine team that was caring for them in the hospital. All persons named by patients were checked against the patients' medical record to identify the named person as one of their inpatient physicians or trainees (attending, resident, intern, medical student), primary care physician, subspecialist, nurse, or other person. Descriptive statistics were used to summarize the ability of patients to identify their inpatient physicians. Chi‐square tests and multivariate logistic regression were used to test the effect of demographic factors (race, age, etc.) and system factors (admitted by float team, length of stay, etc.) on patient ability to identify inpatient physicians.
Results:
Interviews were carried out with 2069/2479 (83%) between the July 2005 and April 2006 academic year. Of those interviewed, 742 patients were excluded because of impaired cognitive function. Of the remaining patients, 77% (1026/1327) were not able to name anyone when asked to identify an inpatient physician in charge of their care. For the 301 patients who responded with at least 1 name, only 70 (23%) were able to correctly identify 1 inpatient physician on their team. Patients often named specialists (127, 42%), or their PCP (21, 7%). In univariate analysis, African American race, not being a high school graduate, older age, and being admitted by a float team were all associated with a diminished ability to identify an inpatient physician. In multivariate analysis, patients who were African American (OR = 0.52, 95% CI: 0.30‐0.88, P = .016) or admitted by a float team (OR = 0.50, 95% CI: 0.26‐0.95, P = .035) were half as likely to correctly identify their inpatient physicians. Those with at least a high school education were nearly twice as likely to correctly identify an inpatient physician (OR = 1.94, 95% CI: 1.13‐3.31, P = .015).
Conclusions:
Few patients can identify their inpatient physicians, suggesting that most patients do not know who is caring for them in the hospital. African American, less educated patients are less likely to correctly identify their inpatient physicians. Use of a night float further limits patients' ability to identify their inpatient physicians. Academic hospitals should focus on improving the ability of patients to understand the names and roles of their inpatient physicians.
Author Disclosure:
V. Arora, None; A. Mehrotra, None; R. Ginde, None; M. Tormey, None; D. Meltzer, None.