Monday, July 19, 2010

MD/sq ft ratio

I'm wondering what the doctor per square foot ratio is for this facility. There are literally doctors, residents and soon-to-be doctors EVERYWHERE! You can tell the residents because they roam the halls in small packs. They are aware of the dangers of moving across the landscape alone, for fear that a predatory Attending or Chief Resident might corner and disembowel.

They scramble to and fro, whispering to one another, discussing lab values and differential diagnoses, looking to see what their cohorts know and don't know. There appears to be a leadership structure, at least in the packs that I have been able to observe closely. It seems as though one Resident asserts their dominance and leads the conversation. From my most recent observations however, it does not evident whether or not this leadership position is bestowed or assumed based on any measure of competence.

In the small pack I watched this morning, the lead Resident was the oldest, tallest male. It was readily apparent though that the youngest, shortest female actually had all the answers. The entire group looked to her for information regarding the patient, the patient's ailments and the best course of action, then turned to alpha male to repeat her suggestion and issue a treatment plan...which he issued in the form of a question directed at alpha female..."Right?"

Sometimes a pack of residents is found trailing behind a Chief Resident or Attending. They can be seen a few steps behind and madly shuffling through papers, reference books and patient summaries, terrified to be caught without an answer. Each attending appears to have their own "style" of interacting with their subordinates. You can tell those that walk quickly and carry a big stick from those that exhibit more of a maternal/paternal method. The hierarchy is always there, but the residents attached to those subscribing to the parental style seem less...scared.

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