Do we practice what we preach? Comparing the patients of faculty and residents.
OBJECTIVE
In academic family practice centers, the distribution of patients between faculty and residents influences the educational milieu. The medical literature has rarely addressed the differential case mix within the ambulatory medical educational setting. The goal of this study was to compare the characteristics of patient visits to resident and faculty physicians in seven community-based, university-affiliated family practice programs.


METHODS
Using the National Ambulatory Care Survey instrument and protocol, 98 faculty and resident physicians recorded their ambulatory patient visits for one randomly selected week between July 1991 and June 1992 (n = 1,498).


RESULTS
Patients of resident physicians were younger, more likely to be nonwhite (21.7% vs 9.8%, P < .001), and more likely to be reimbursed by Medicaid (34.2% vs 14.3%, P < .001) than patients of faculty physicians. Despite these patient differences, the spectrum of clinical problems was similar. There were minimal differences in the delivery of diagnostic services and therapeutic services.


CONCLUSIONS
The patients seen by residents and faculty differ in important demographic characteristics. These differences could adversely affect the education of resident physicians. Academic family practice centers should actively monitor the age/gender/payment profile of resident and faculty patient panels and assign patients to achieve a desirable case mix for resident education. The differential racial distribution of faculty and resident visits suggests an unidentified systematic bias in patient assignment that warrants further investigation.
Scheid
D
D
Akron General Medical Center, Ohio, USA.
Logue
E
E
Gilchrist
V J
VJ
Gillanders
W R
WR
Miller
R S
RS
Iverson
D
D
Oprandi
A M
AM
Weldy
D L
DL
D000046:Academic Medical Centers; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003151:Community Health Centers; D003710:Demography; D005180:Faculty, Medical / Q000706:statistics & numerical data*; D005194:Family Practice / Q000193:education* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007223:Infant; D007396:Internship and Residency / Q000706:statistics & numerical data*; D008297:Male; D008484:Medicaid; D008875:Middle Aged; D010361:Patients / Q000706:statistics & numerical data*; D013663:Teaching; D014481:United States