Activities of the attending physician in the ambulatory setting: what part is teaching?

The attending physician is a valuable resource in the ambulatory care teaching setting. To describe the nature of attending physician activities, seven faculty physicians were observed during 214 three-hour clinic sessions at two sites of a family medicine training program. Only 53% of attending physician time involved clinical teaching activities, with only half of this portion spent in consultation with or seeing the patients of trainees. The patient volume of the clinic session did not affect total time spent in consultation, but the rate at which trainees consulted attending physicians decreased during busier sessions. This study represents a first step toward understanding the educational, organizational, and economic implications of attending physician activities in the ambulatory setting.