GRADUATE MEDICAL EDUCATION

POLICIES & PROCEDURES

Internal Medicine Guidelines for Physicians
Admitting Patients to the Teaching Service
 Policy Number: 28
Date Issued:5/2002
Prior Revision Date:2/2004
  Date Revised: 9/2006
PURPOSE To define the policy and procedure for guidelines for admitting patients to the Teaching Service at Presbyterian Hospital of Dallas
SCOPE Applies to all interns and residents (hereafter will be referred to as trainees or housestaff) in the Internal Medicine training program and all Admitting Physicians of the training program on the Presbyterian Hospital of Dallas campus.
PROVISIONS
  1. When the Admitting Physician has a case to admit, please call the Page Operator at x8480 and page the Internal Medicine Resident on call.  If the resident accepts the case, which should happen in all but the most unusual circumstances, the resident will assign the case to his/her intern.
  2. The resident should be given a brief synopsis of the case by the admitting physician. The housestaff's plan for evaluation and treatment should be reviewed by the admitting physician. This is a “teaching opportunity” for the resident and intern.
  3. Residents or interns must write all orders, including admissions and daily orders.  Attendings are not allowed to write order on patients admitted to the teaching service.  The resident the intern will also write a complete history and physical.
  4.   Residents are expected to review the patient’s progress with the Admitting Physician every day.  The residents have been instructed to call the Admitting Physician daily if they do not see him or her in the hospital. 
  5. If the patient on teaching service is transferred to the ICU, the Admitting Physician must see the patient within 2 hours of transfer, as per hospital policy.
  6. The resident will arrange for an efficient discharge plan, write the prescriptions, and dictate the discharge summary.
  7. For billing, the Admitting Physician must do the following: 
    • See the patient daily.
    • Do the significant portion of the exam or watch the resident do it.
    • Perform a history and physical separate from those of the intern and resident.
    • The Admitting Physicians progress notes can be linked to the residents note as long as the Admitting Physician documents that he or she saw the patient and performed a pertinent exam.
    • Billing for a patient on teaching service is noted with the modifier “GC”.
MARK FELDMAN, M.D.
Chairman, Internal Medicine Program Director, Internal Medicine 		BRUCE BOUGENO
Vice President, Medical Staff Affairs