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Health

Who's who in the exam room

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Have you ever gone into a doctor’s appointment and been left wondering who took your blood pressure? Who asked about that prescription? Chances are you’re not alone.

Sometimes it’s difficult to know who’s who in the exam room. This week on “Take Care,” Dr. Robert Shmerling, associate physician and clinical chief of rheumatology at Beth Israel Deaconess Medical Center and associate professor in medicine at Harvard Medical School, talks about this exam room dilemma.

You would think a doctor would already know who’s who in a medical office, but even Shmerling wasn’t sure who was tending to him when he went in for a minor surgery recently. Shmerling was seen first by a younger man, whom he assumed was the primary hand surgeon, until the actual surgeon came in minutes later.

For this reason, doctors typically wear ID badges with their name and title. However, in private practices and other medical settings, this may not be routine. In a perfect world, medical professionals would be sure to introduce themselves upon first meeting patients, although this isn’t guaranteed, says Shmerling.

But still, it is important for patients to understand what’s going on, and with so many roles in any given office, it’s no wonder it can be hard to keep track. According to Shmerling, an office can have any number of receptionists, trainees, health assistants, hospitalists, nurses, nurse practitioners, and primary doctors -- all of whom are potentially speaking with a patient within the course of a single appointment.

This is especially common in training hospitals, which are brimming with medical students, residents, and fellowship trainees. The hospitals have their permanent staff, explains Shmerling, as well as students and trainees who are still learning the ropes. Becoming a doctor requires many stages, and after medical school, most graduates becoming “residents” in their particular field and after that, they can do additional practice known as a “fellowship.” For example, in Shmerling’s case, he did a rheumatology fellowship before becoming an arthritis doctor.

So what does this mean for the patient? Well for one thing, you do have the right to request that you only see your primary doctor, should all the unfamiliar faces make you uncomfortable. In a teaching hospital, however, Shmerling warns that this might not always be timely or efficient, which is why trainees can be helpful with keeping things running smoothly. And it can’t hurt to ask, says Shmerling, who you’re speaking with and their role at the hospital. He recommends a light introduction -- something as simple as, “I’m sorry, I’ve seen a lot of new faces today, what’s your name again?” which should help clear up any confusion, without putting off the staff.