Whitney Palmer

Are Medical Grand Rounds Still Relevant?

Published in the American Hospital Association’s June 2010 Hospitals & Health Networks

By Whitney L.J. Howell

Making sessions more patient-focused, using video can improve attendance

When it comes to medical grand rounds, doctors vote with their feet. As doubts about the conference’s effectiveness have grown, fewer physicians have cast their ballots in favor of the weekly lecture, pushing some hospitals to revamp the time-honored tradition.

Over the past decade, medical grand rounds attendance has declined widely, says Robert Wachter, M.D., chief of medical service at the University of California San Francisco Medical Center. Attendance at UCSF’s medical grand rounds has dropped 5 to 10 percent annually since 2000. Conferences that drew 75 to 150 physicians in 2000 attracted fewer than half that in 2009.

According to Scott Wright, M.D., Johns Hopkins Bayview Medical Center general medical service attending physician and co-author of the 2003 Academic Medicine article “Re-examining the Value of Medical Grand Rounds,” hospitals must recast the concept if they want it to remain relevant.

“It’s easier to give a lecture, plain and simple,” he says. “But for MGR to be meaningful, you must include patients or their families, pick topics that aren’t available at national meetings, and give doctors a chance to ask questions.”

Still, enticing doctors to give up an hour for grand rounds is difficult, Wright says, because they often have heavy patient care or teaching responsibilities.

But extra pressures should not prevent doctors from participating, contends Laura Werts, manager of continuing medical education at Cincinnati Children’s Hospital. Through videoconferencing with off-site locations, DVD dissemination and the Internet, Cincinnati Children’s increased patient-focused pediatric medical grand round attendance. It has remained steady since 2006.

“Our videoconferencing and Internet grand rounds have been successful. We have some affiliated hospitals that bring their physicians together to watch our grand rounds online,” Werts says. “They still want that person-to-person connection.”

It is this social aspect that makes grand rounds worth saving, says Larry Smith, M.D., dean of Hofstra University’s School of Medicine. Doctors can find details about the latest health care innovations in many places, but they have very few opportunities to form collegial bonds with physicians outside their specialties. It also leads to improved patient care.

“Socializing face to face continually reminds [doctors] that they belong to a specific professional group. The bonds formed this way can’t be replaced by doing grand rounds any other way,” Smith says. “Plus, as a physician, you’ll always be better prepared to refer a patient if you know the specialist in a different field personally.”

This article 1st appeared in the June 2010 issue of HHN Magazine.

To view the article online:http://www.hhnmag.com/hhnmag_app/jsp/articledisplay.jsp?dcrpath=HHNMAG/Article/data/06JUN2010/1006HHN_Inbox_Physicians&domain=HHNMAG

June 8, 2010 - Posted by wjpalmer | Healthcare | Bob Wachter, future of grand rounds, grand rounds, institutions of grand rounds, online grand rounds, Scott Wright, teleconferencing grand rounds