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For attending inpatient physicians who teach, working several consecutive weeks minimizes service handoffs and provides for more longitudinal evaluation of trainees. Whether length of attending rotation affects patient care is unclear. Investigators at Cook County Hospital in Chicago conducted a crossover noninferiority trial to compare the effects of 2- versus 4-week inpatient rotations.
Sixty-two attending physicians were block randomized to sequences of 2- and 4-week rotations, with washout periods of at least 2 weeks of nonservice time between transitions. During the 1-year study, about 12,000 patients were discharged. Numbers of unplanned postdischarge visits (i.e., emergency department visits, urgent care visits, or hospitalizations wi…