Some Thoughts About Patient Ownership

Abstract

According to Oxford Dictionaries Online, the definition of ownership is ''the act, state, or right of possessing something.''I happen to like this word, because it relates to what I consider the appropriate strategy for teaching and for the management of hospitalized patients with any illness.A few months ago, I was talking to a cardiovascular fellow regarding the care of patients admitted to the hospital in a setting in which medical housestaff are being trained in 2015.Our discussion made me reflect on my own housestaff training at Johns Hopkins many years ago.However, it seemed to me that we had a different attitude about patient care and continuity of care than that which is currently the standard way of training medical housestaff to manage in 2015.During my training, it was quite clear to all of us that tradition dictated that we had primary responsibility for the patients admitted to our ward service.This came from the top (ie, chair of medicine), not from some organization that had very little to do, if anything, with patient care.In those early days, medicine housestaff were assigned to a patient, and that patient became his or her responsibility 24 hours a day, 7 days a week.Of course, we could sign out to our fellow housestaff, but we let it be known that if major problems arose with the patient assigned to us that we be called by our housestaff mate.This concept of ownership of the patient was so ingrained in us at Hopkins that it carried over to later times when we functioned as fellows in training for cardiovascular medicine or as young cardiovascular faculty.In my case, it is carried over through all of my life, and I still feel that if a patient is assigned to me with cardiovascular disease, I am responsible for that patient's management and eventual disposition.