ARE THINGS DIFFERENT IN THE LIGHT OF DAY - A TIME STUDY OF INTERNAL-MEDICINE HOUSE STAFF DAYS

PURPOSE: To determine how internal medicine house staff spend their da ys and compare activities during the day with whose previously observe d during night call. SETTING: University-affiliated Veterans Affairs M edical Center. DESIGN: Two internal medicine house staff teams (one PG Y-1 [postgraduate year] and one PGY-2 or PGY-3) observed during 5 shor t call admitting days. MEASUREMENTS: Time in each activity recorded by trained observers, computed, summed, and compared with that of simila r activities of house staff on night call. RESULTs: House staff admitt ed an average of two patients each day. They spent, on average, 25 min utes per patient performing new patient histories and physical examina tions, 29 minutes charting new patient information, and were interrupt ed after an average of 12 minutes during the new patient evaluation co mpared with 20,19, and 7 minutes at night (p >0.05). The average house officer spent 14 minutes in nonphysician duties and 11 minutes answer ing pages during the day. On average, house staff spent 3 minutes each day talking in person with patients' families. CONCLUSIONs: A signifi cant amount of time each day was spent performing nonphysician duties. Little time was spent evaluating each patient or in person witb patie nts' families and similar amounts of time were spent in charting and i n patient evaluation. House staff appeared to spend more time with new patients during the day than they did at night, although this finding was not statistically significant. As noted during. night call, evalu ations were frequently interrupted. Future studies should examine why house staff choose to distribute their time in the manner described in this and similar studies.