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November 19, 1982

Preparation and 'Postparation'

JAMA. 1982;248(19):2504. doi:10.1001/jama.1982.03330190066039

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On our medical service in a large urban medical center, we have "floor attendings." These are physicians who review with the house staff and medical students the clinical problems on the general medical floors. The floor attendings may be subspecialists or general internists in private practice, and some feel anxious when asked to teach the entire range of internal medicine. To aid them, we have developed the techniques of preparation and "postparation."

Patients enter our institution with relatively well-defined distributions of disease: 27% of admissions to the medical service are primarily for diseases of the circulatory system, 16% for neoplasms, 11% for diseases of the digestive system, and so on. Of patients with heart disease, 40% suffer from ischemic heart disease, the most common form of circulatory disorder. By preparing accordingly with core knowledge from colleagues and from textbooks, and with recent information from medical journals, our floor attendings are