Will the Real Doctor Please Stand Up?

The Effectiveness of the Multiple-Attending-Physicians System Compared With the Single Attending-Physician System in Inpatient Setting: A Mixed-Method Study

“… 11 However, several studies indicate that the involvement of multiple professionals in a patient’s care could cause confusion and frustration among physicians, patients, and co-working staff in inpatient care, especially in ICU and end-of-life care. 18 - 22 Management of the end-of-life decision-making varied in relation to multiple and shifting attending responsibilities, and some patient’s families and clinicians were confused about who was making patient care decisions and with whom they should confer. 18 Many patients were unable to name anyone when asked to identify an inpatient physician in charge of their care, 21 and nearly 50% of responding attending physicians knew dying patients for less than 48 hours.…”

The Clinical Performance and Effectiveness of the Multiple-Attending-Physicians System Compared with the Single-Attending-Physician System in Inpatient Setting: A Mixed-Method Study

“…A cross-sectional study demonstrated that with more physicians, the accuracy in clinical practice under the team approach will improve [11]. However, several studies indicate that the involvement of multiple professionals in a patient's care could cause confusion and frustration among physicians, patients, and co-working staff in inpatient care, especially in ICU and end-of-life care [18][19][20][21][22]. Management of the endof-life decision-making varied in relation to multiple and shifting attending responsibilities, and some patient's families and clinicians were confused about who was making patient care decisions and with whom they should confer [18].…”

Who Is Attending? End-of-Life Decision Making in the Intensive Care Unit

“…The multiplicity of physicians who may be involved in care has been critiqued as leading to an “erosion of the sacred trust” between physicians and patients 18 and confusion about who is in charge of patient care. 19 In a recent study of acute care medical patients asked to name “the inpatient physician in charge of their care,” 75% of them could not identify anyone , indicating that they did not know whom to contact for explanations or requests. 20 Recently in a study of the last 3 days of life of patients who died in a large teaching hospital, most providers caring for them reported knowing their patients for <24 hours.…”