Comparing care at teaching hospitals to non-teaching hospitals

 

A Harvard study favors teaching hospitals, but read why that is not consistently true

 
June 8, 2017

In May 2017, the Journal of the American Medical Association published the results of a study looking into the difference in outcomes between patients admitted to major teaching hospitals, versus patients admitted to minor teaching hospitals or non-teaching hospitals.

Residents and fellows

After graduating from medical schools, nearly all doctors go on to complete additional hands-on training in what is called a residency. During this training period, the recent-medical-school graduates are called residents. After completing a residency, some doctors get additional specialized training in a fellowship, during which they are referred to as fellows.

What is a teaching hospital?

A teaching hospital is a hospital that hosts a residency or fellowship program. Residents and fellows participate in the care and treatment of the teaching hospital’s patients as a part of their training, and are supervised by fully-trained faculty members called attending physicians.

Major teaching hospitals host a variety of residencies, with many residents and fellows on their staffs. Minor teaching hospitals occasionally have a few residents working at their facilities.

Teaching hospitals have a relationship with a medical school or, in some cases, have their own residency programs. If you seek treatment at a teaching hospital, a resident or follow will almost certainly be involved in your care. In fact, it is likely that you will see residents and fellows more often than attending physicians.

Houston Methodist Hospital, for instance, sponsors its own residency programs in a number of specialties.

Baylor College of Medicine residents and fellows train at Baylor St. Luke’s Medical Center, Children’s Hospital of San Antonio, Harris Health (Ben Taub General Hospital and Lyndon B. Johnson “LBJ” Hospital), MD Anderson Cancer Center, Menninger, Texas Children’s Hospital, Memorial Hermann TIRR, and the Houston VA Medical Center.

The University of Texas Health Science Center at Houston’s residents and fellows train at Memorial Hermann-Texas Medical Center, Children’s Memorial Hermann Hospital, Harris Health System’s Lyndon B. Johnson Hospital, UT Harris County Psychiatric Center, Texas Heart Institute at CHI St. Luke’s Health Center-Baylor St. Luke’s Medical Center, and MD Anderson Cancer Center.

Quality of care at teaching hospitals

The study that I referenced at the beginning to this article was done by researchers at the Harvard University School of Public Health, who studied data on 21.5 million hospitalizations of Medicare patients. The hospital admissions were for 15 common medical issues, including pneumonia, congestive heart failure, and stroke, and for six surgical procedures, including hip replacement, coronary artery bypass grafting, and colectomy.

The researchers concluded that Medicare patients admitted to major teaching hospitals are less likely to die than patients admitted to minor teaching hospitals or non-teaching hospitals.

Overall, this does not surprise me because there are some incredibly bright and talented doctors in major teaching hospitals, like those found in the Texas Medical Center. But the results need to be taken with a grain of salt.

You probably wonder why.

It depends on the day and time you go to the hospital. If you need care on a day and time when the fully-trained attending physicians are present in the hospital, you are likely to receive excellent care. On the other hand, if it is late at night or on a weekend or holiday when you need care, a junior resident will likely be providing the hands-on care, and the attending physicians may only participate by phone.

The latter situation makes me think of a client I represented who went to Houston Methodist Hospital’s emergency room one evening with classic stroke symptoms. Despite the fact that the hospital is a certified comprehensive stroke center, the neurology resident who saw her botched the diagnosis and told her she was just having a psychogenic reaction. The stroke attending doctor never even saw her before she was quickly discharged. Sadly, my client did have a massive stroke and will suffer from the injuries and impairments that she experienced for the rest of her life.

For this reason, if it is not an emergency, I recommend avoiding the hospital on nights, weekends, and holidays.

We are here to help

If you or someone you care for has been seriously injured by negligent or bad care at a teaching hospital, or at any other type of hospital or facility, call Painter Law Firm, at 281-580-8800, for a free consultation with an experienced medical malpractice attorney.

There are lots of residency options for doctors

Medical residencies and teaching hospitals are a big business. Medical schools and some large hospital themselves offer residency programs in a variety of medical specialties.  According to the Association of Medical Colleges, residencies are available in the following specialties.

You can click on any specialty below to learn about the requirements to graduate from the residency program.

· Abdominal Radiology (Radiology-Diagnostic)

· Addiction Psychiatry 

· Adolescent Medicine (Pediatrics) 

· Adult Reconstructive Orthopaedics  (Orthopaedic Surgery)

· Advanced Heart Failure & Transplant Cardiology (Internal Medicine)

· Allergy & Immunology

· Anesthesiology

· Biochemical Genetics  (Medical Genetics)

· Blood Banking - Transfusion Medicine (Pathology-Anatomic & Clinical)

· Cardiothoracic Radiology (Radiology-Diagnostic)

· Cardiovascular Disease (Internal Medicine)

· Chemical Pathology Pathology-Anatomic & Clinical

· Child & Adolescent Psychiatry (Psychiatry)

· Child Abuse Pediatrics (Pediatrics)

· Child Neurology (Neurology)

· Clinical & Laboratory Immunology (Allergy & Immunology)

· Clinical Cardiac Electrophysiology (Internal Medicine)

· Clinical Neurophysiology (Neurology)

· Colon & Rectal Surgery

· Congenital Cardiac Surgery (Thoracic Surgery)

· Craniofacial Surgery (Plastic Surgery)

· Critical Care Medicine (Anesthesiology)

· Critical Care Medicine (Internal Medicine)

· Cytopathology (Pathology-Anatomic & Clinical)

· Dermatology

· Dermatopathology (Dermatology)

· Developmental-Behavioral Pediatrics (Pediatrics)

· Emergency Medicine

· Endocrinology, Diabetes & Metabolism (Internal Medicine)

· Endovascular Surgical Neuroradiology (Neurological Surgery)

· Endovascular Surgical Neuroradiology (Neurology)

· Endovascular Surgical Neuroradiology (Radiology-Diagnostic)

· Family Medicine

· Family Practice

· Female Pelvic Medicine & Reconstructive Surgery (Obstetrics & Gynecology)

· Foot & Ankle Orthopaedics  (Orthopaedic Surgery)

· Forensic Pathology (Pathology-Anatomic & Clinical)

· Forensic Psychiatry (Psychiatry)

· Gastroenterology (Internal Medicine)

· Geriatric Medicine (Family Medicine)

· Geriatric Medicine (Internal Medicine)

· Geriatric Medicine (Family Practice)

· Geriatric Psychiatry (Psychiatry)

· Hand Surgery (Orthopaedic Surgery(

· Hand Surgery (Plastic Surgery)

· Hand Surgery (Surgery-General)

· Hematology (Internal Medicine)

· Hematology (Pathology-Anatomic & Clinical)

· Hematology & Oncology (Internal Medicine)

· Infectious Disease (Internal Medicine)

· Internal Medicine

· Internal Medicine-Pediatrics

· Interventional Cardiology (Internal Medicine)

· Medical Genetics

· Medical Microbiology (Pathology-Anatomic & Clinical)

· Medical Toxicology (Emergency Medicine)

· Medical Toxicology (Preventive Medicine)

· Molecular Genetic Pathology (Medical Genetics)

· Muscoskeletal Radiology (Radiology-Diagnostic)

· Musculoskeletal Oncology (Orthopaedic Surgery)

· Neonatal-Perinatal Medicine (Pediatrics)

· Nephrology (Internal Medicine)

· Neurological Surgery

· Neurology

· Neuromuscular Medicine (Neurology)

· Neuromuscular Medicine (Physical Medicine & Rehabilitation)

· Neuropathology (Pathology-Anatomic & Clinical)

· Neuroradiology (Radiology-Diagnostic)

· Nuclear Medicine

· Nuclear Radiology (Radiology-Diagnostic)

· Obstetric Anesthesiology (Anesthesiology)

· Obstetrics & Gynecology

· Oncology (Internal Medicine)

· Ophthalmic Plastic & Reconstructive Surgery (Ophthalmology)

· Ophthalmology

· Orthopaedic Sports Medicine (Orthopaedic Surgery)

· Orthopaedic Surgery

· Orthopaedic Surgery of the Spine (Orthopaedic Surgery)

· Orthopaedic Trauma (Orthopaedic Surgery)

· Otolaryngology

· Otology-Neurotology (Otolaryngology)

· Pain Medicine (Anesthesiology)

· Pain Medicine (Neurology)

· Pain Medicine (Physical Medicine & Rehabilitation)

· Pathology-Anatomic & Clinical

· Pediatric Anesthesiology (Anesthesiology)

· Pediatric Cardiology (Pediatrics)

· Pediatric Critical Care Medicine (Pediatrics)

· Pediatric Emergency Medicine (Emergency Medicine)

· Pediatric Emergency Medicine (Pediatrics)

· Pediatric Endocrinology (Pediatrics)

· Pediatric Gastroenterology (Pediatrics)

· Pediatric Hematology-Oncology (Pediatrics)

· Pediatric Infectious Diseases (Pediatrics)

· Pediatric Nephrology (Pediatrics)

· Pediatric Orthopaedics (Orthopaedic Surgery)

· Pediatric Otolaryngology (Otolaryngology)

· Pediatric Pathology (Pathology-Anatomic & Clinical)

· Pediatric Pulmonology (Pediatrics)

· Pediatric Radiology (Radiology-Diagnostic)

· Pediatric Rheumatology (Pediatrics)

· Pediatric Sports Medicine (Pediatrics)

· Pediatric Surgery (Surgery-General)

· Pediatric Transplant Hepatology (Pediatrics)

· Pediatric Urology (Urology)

· Pediatrics

· Physical Medicine & Rehabilitation

· Plastic Surgery

· Preventive Medicine

· Procedural Dermatology (Dermatology)

· Psychiatry

· Pulmonary Disease (Internal Medicine)

· Pulmonary Disease & Critical Care Medicine (Internal Medicine)

· Radiation Oncology

· Radiology-Diagnostic

· Rheumatology Internal Medicine

· Sleep Medicine

· Spinal Cord Injury Medicine (Physical Medicine & Rehabilitation)

· Sports Medicine (Emergency Medicine)

· Sports Medicine (Family Medicine)

· Sports Medicine (Internal Medicine)

· Sports Medicine (Physical Medicine & Rehabilitation)

· Surgery-General

· Surgical Critical Care (Surgery-General)

· Thoracic Surgery

· Thoracic Surgery-Integrated (Thoracic Surgery)

· Transplant Hepatology (Internal Medicine)

· Urology

· Vascular & Interventional Radiology (Radiology-Diagnostic)

· Vascular Surgery (Surgery-General)

Robert Painter

Robert Painter is a medical malpractice lawyer at Painter Law Firm PLLC.

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