What Should an Intern Do When She Disagrees With the Attending?

Area of Science:

• Medical Ethics
• Physician Education
• Clinical Decision-Making

Background:

• Disagreements between medical residents and attending physicians are frequent occurrences in clinical settings.
• This article examines an ethical case involving a conflict over patient discharge recommendations.

Observation:

• An intern and attending physician disagreed on patient disposition, with the attending recommending prolonged hospitalization without clear justification.
• Commentaries explored the intern's moral distress, the need for conflict resolution training, and the distinct responsibilities of residents versus attendings.

Findings:

• Attending physicians' dual roles as clinicians and educators can create conflicts.
• Training programs should foster environments where questioning is encouraged to support both trainees and attendings.
• Shared decision-making with patients and families is crucial, especially in uncertain situations.

Implications:

• Enhanced communication and conflict resolution training for medical trainees is essential.
• Residency programs must actively support attending physicians in navigating educational and clinical responsibilities.
• Implementing family-centered rounds can improve shared decision-making and patient outcomes.