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David B. Hoyt, MD
San Diego, Calif

Arch Surg. 2003;138:51.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

From this article it would seem that in-house attending physicians have little effect on outcome, whereas a commitment to a fellowship training program does. We must be cautious in interpreting these results. The amount of data collected, though concurrent, is small for the number of centers studied. In each cohort in each trauma center, there are on average less than 20 patients. The injury matching is balanced by Injury Severity Score, but the Abbreviated Injury Score used between centers is not standardized, which introduces variability.

The authors assume that self-designation of in-house vs out-of-house leads to an actual difference in surgeon response. This was not measured or controlled for. It is possible that attending physician arrival was rapid for all severely injured patients in both groups. The composition of resuscitation teams varies in hospitals. Involvement of an experienced attending emergency department physician in an out-of-house hospital . . . [Full Text of this Article]

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Patient Outcomes in Academic Medical Centers: Influence of Fellowship Programs and In-house On-Call Attending Surgeon
Saman Arbabi, Gregory J. Jurkovich, Frederick P. Rivara, Avery B. Nathens, Maria Moore, Gerald B. Demarest, and Ronald V. Maier
Arch Surg. 2003;138(1):47-51.
ABSTRACT | FULL TEXT