Health Care Team (HCT)

Attending Physicians are the doctors who are responsible for supervising, teaching, and training interns, residents, fellows, and medical students. They are ultimately responsible for all aspects of patient care.

The Attending assumes primary care for the patient and has the legal and ethical responsibility for directing the care of the patient. He or she must see each patient every day, review treatment plans with their residents, and document his or her supervision of the patient’s management.

The Attending Physician must have completed an accredited residency program and usually will have obtained specialty board certification. Teaching Attendings often have additional fellowship training and usually have faculty appointments.

Attending Physicians are supervised in the hospital setting by the Chairs of their departments. If affiliated with a medical school, they are also supervised by the Chairs of the medical schools.

The schedules of Attending Physicians are very diverse, depending on the field of practice. For example, in internal medicine, Attending Physicians may begin the day with an educational activity such as morning report, then may go to the hospital wards to conduct bedside teaching rounds with medical students and residents and perform consultations as needed. They may see patients in an outpatient site with residents and fellows. In addition, Attendings may spend some time doing clinical or basic science research and tend to various administrative activities.

To become an Attending Physician in the U.S. health care system, a physician must:

• complete an accredited residency program
• obtain state licensure
• be eligible for or have obtained specialty board certification in his or her respective field

All Attending Physicians must be licensed to practice medicine. Licensure is a legal designation given by individual states. An Attending Physician may be licensed in one or more states; however, there is no national licensure, and licensure in one state is not necessarily transferable to another state.

Eligibility for specialty board certification is determined independently by each of the specialties of medicine (internal medicine, family medicine, general surgery, obstetrics and gynecology, etc.). Each specialty board determines its own minimal requirements of competency, including length of residency training and certification examination requirements. Some states require a minimum number of continuing medical education (CME) hours per year to maintain state licensure.

In the hospital setting, patients are assigned to an Attending Physician as soon as they are admitted. If the patient has an Attending Physician outside the hospital, and that physician has admitting privileges at the hospital, then that physician will remain the patient’s primary physician. If not, an Attending Physician is assigned to the patient.

There is no single organization for all Attending Physicians. A list of medical specialty societies can be found at the website of the Council of Medical Specialty Societies.