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January 23/30, 2013

Attending Physicians on Ward Rounds—Reply

Author Affiliations

Letters Section Editor: Jody W. Zylke, MD, Senior Editor.

Author Affiliations: University of California, San Francisco (Dr Wachter); and Stanford University, Palo Alto, California (Dr Verghese; abrahamv@stanford.edu).

JAMA. 2013;309(4):341. doi:10.1001/jama.2012.65894

In Reply: It is interesting—and reassuring—that trainees appear to value hearing their attending physician's thought processes more than a recitation of evidence-based literature. The ubiquitous availability of online resources has had the effect of turning clinical evidence into a commodity, which is a good thing. Wisdom and experience are harder to commoditize, and attending physicians are uniquely positioned to offer them to their trainees.

Like Dr Centor and colleagues, we believe that effective faculty development programs can allow junior attending physicians to traverse their learning curves more rapidly. Junior faculty may be less comfortable “thinking out loud” and more inclined to equate teaching with discussing the results of the latest literature. Providing such faculty with the tools to teach more effectively, and to appreciate the value of sharing their clinical wisdom, should be a high priority. On the other hand, Centor and colleagues' findings should not be taken as license by senior faculty to not keep up with the literature. The attending physician's thought process must be based on a foundation of an up-to-date understanding of the literature.