Attending:

• Admission of a patient to the teaching service requires that the Internal Medicine Resident on call be paged at 214-345-8480.
• The Attending will provide the resident with a brief synopsis of the case.
• The Attending must be available in person or by phone/beeper to discuss the plan of care for the patient. If he/she will not be available, he/she must tell the resident who will be responsible for discussing the admit plan of care. The attending covering must have some knowledge of the patient admitted.
• The attending or his/her coverage must be available for consultation with the residents twenty four hours a day.
• The attending must see the patient daily, review the residents notes and orders and discuss the management with the resident. The authority of the attending is final.
• If for some unknown reason, the attending is not available, the resident will call any one of the key faculty members or the Chairman of the Department:
  • Gary Weinstein - 214-345-4062
  • Sonya Merrill - 214-345-7991
  • Andres Quicino - 214-345-4258
  • John Harper - 214-345-7878
  • Mitch Carroll - 214-345-5955
  • Mark Feldman - 214-345-7881
• The key faculty member will advise the resident regarding the care of the patient until the attending can be located.

Resident

• The second or third year resident on call for Internal Medicine will accept admissions from Presbyterian Hospital of Dallas Internal Medicine Attendings (up to 10/night). He/she may also accept admission from the Neurologist of Presbyterian Hospital of Dallas. He/she may not accept admissions from any other department.
• The resident should assess the patient. He/she is responsible for the care delivered to the patient by the intern under his/her supervision. The resident must be aware of all orders and notes written by the intern in the chart daily. The resident’s authority supercedes that of the intern. If the intern is in disagreement with the resident, it should be discussed together with the attending physician.
• During a MET, the most senior resident present will be in charge.

• The intern on call for Internal Medicine will accept admissions form the resident he/she is working with.
• The intern will make and immediate assessment of the patient, initiate a plan of care and then proceed with a full history, physical and orders. The plan of care and orders should be discussed with the resident first and then the attending. This must be done on a daily basis.
• Interns must communicate daily with the attending either by a face to face meeting or by phone. There are no exceptions to this rule.
• Interns must communicate with the resident when he/she make a significant change in the patient’s plan of care.

ER Rotation:

• The interns/residents will see the patient independently. The ER attending will review the findings and discuss the plan of care with the resident. The ER attending will give autonomy commensurate with the level of training. No patient will be discharged from the ER without discussion with the attending prior to discharge.

• The interns/residents will see the patient independently. The attending will fully examine the patient and discuss the case with the intern/resident in terms of findings, and plan of care. All orders will be written by the intern/resident. The intern/resident is responsible for calling and communicating with the attending of record whenever a recommendation regarding the plan of care for the patient is made by the consulting team.

Attending:

• Responsible for the oversig ht or the residents’ care for each patient in the clinic.
• Responsible for reviewing each progress note and when necessary, discussing alternative plans of care with the resident.
• Responsible for seeing every patient with the interns during the first 6 months of internship.
• The final authority regarding patient care issues.

Resident:

• All R2’s and R3’s are responsible for seeing 5 to 7 patients per clinic day.
• They must assess each patient and address their medical problems thoroughly.
• They must inform all their patients of their lab and test results.
• They must communicate directly to any physician to whom they are referring their patient.
• They must return patient phone calls within _ hour of receiving them.
• They must discuss any difficult management issue with the attending.

Interns:

• All of the responsibilities as listed under Resident except:
• Will only be scheduled for 3 patients during the 1st three months of internship.