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Residents rely on council for advocacy by Cindy Abole Public Relations For the past year, MUSC’s resident physicians have looked to a group of elected peers for leadership and their opinions on house staff issues and the medical center. This group, the MUSC House Staff Council, has responded quickly and thoughtfully on matters brought to its attention by residents. The results are improvements and needed adjustments to conditions, allowances and ancillary benefits to enhance the clinicians’ quality of life and work.   Established in 2006, the council’s goal is to provide representation to more than 580 specialty and sub-specialty resident physicians who work in 50 graduate residency programs throughout the hospital system.   So far, it’s been an active year with little chance of slowing as it relates to potential house staff issues, according to Eric Wilson, M.D., a fourth-year Department of  General Surgery Resident and 2007-08 council chair.   For instance, the council has addressed a variety of new and old issues stemming from the previous year’s council leadership, which was able to secure salary adjustments for resident physicians. The residents’ salaries now are aligned with other similar residency programs in the Southeast.   Council members also worked with MUSC’s Graduate Medical Education (GME) office last fall to establish a new resident religious observance policy. The policy was researched and created by residents David Pucci, D.O., and Bassam Kadry, M.D., Department of Anesthesia. Pucci and Kadry evaluated other medical residency programs and helped draft the new policy, which recognizes physician trainees and their right to observe religious holidays and practices with a priority on patient care. For example, a resident can take planned leave with permission from their program chief and assurance of acceptable patient coverage.   “It was appropriate that we were asked to take the lead on addressing this issue since we’re representatives of house staff as opposed to administrators drafting the policy. We were able to submit the draft and easily pass it with the support of the GME office and hospital leadership,” Wilson said.   The council also collaborated with the GME Office and hospital administration throughout the opening of ART, which opened Feb. 5. House staff worked with Pat Cawley, M.D., medical director, to address several issues including call suite security (no locking door),  equipment issues, and coordinating meal services after hours at ART. As a result, the hospital quickly installed a secured-card-entry system in the resident call suite.   Other issues resolved quickly included collaboration with the City of Charleston and mayor’s office in establishing a crosswalk last fall between the county parking garage and corner of Courtenay Drive and Doughty Street. The group also created a after-hours meal request system that allowed residents, who work at ART, to pre-order meals from the cafeteria and later, receive a hot meal stored at the resident call rooms.   “In many cases, residents aren’t finished with surgery or patient rounds until past 7 p.m. when the ART cafeteria closes and there’s no food available for them,” Wilson said. “This solution provides a great alternative for residents. At the same time, it has encouraged residents to learn how to plan with such issues.”   “It’s great that the council serves as another venue for the medical center to gain input and engage physicians,” said Cawley. “Historically, hospital leadership has focused solely on input from attending physicians rather than house staff. Today, the house staff is recognized as the drivers of care and is at the front end of caring for patients. The more feedback we receive from residents and hospital staff, the better we can plan. Together, we can work at creating a more accurate, improved system for patient safety and health care excellence.”   Laurel Bailey, M.D., was a chief resident in the Department of Internal Medicine and served on the hospital's GME committee. Bailey feels the council has helped to improve communications between hospital leaders and resident physicians.   “It can be a little intimidating for a resident who wants to communicate an idea or issue as it relates to the house staff,” said Bailey. “It’s important for residents and the hospital to maintain a positive working relationship. I see the value of the house staff council as an advocacy group that residents can take issues to and present to the GME office and hospital executives.”   Meanwhile, residents, the GME office and hospital leadership continue to work together on issues including resident in-house on-call meals, insurance benefits, computerized physician order entry and orientation funding for incoming staff.   One of the best things about the council is that it regularly brings residents from different programs together and conducts program reports of on-going activities, issues and hot topics affecting specific program areas. In addition, interest in establishing some off-campus, community activities or sports league are being discussed among residents, according to Wilson.   “Any resident is invited to attend the monthly meetings regarding house staff concerns. Each program has a representative to the council or they can e-mail or contact any of the council officers regarding their concerns or questions,” Wilson said, who was among council members to regularly present updates at MUSC Board of Trustees meetings. The council is set to conduct elections for the 2008-09 year in August.   “On a long-term perspective, hospitals and physicians have to work harder at improving patient care,” Cawley said. “It’s my hope that the council moves forward from managing every day hospital operations and functions to focusing on more collaborative activities.” 2007-08 Resident representatives, alternates to hospital committees MUHA Hospital Blood Useage, Tissue and Autopsy— Kelly Rose, Pathology; Jimmy Wells, Internal Medicine and Nick Paphitis, Internal Medicine Charleston County Medical Society—Josh Glenn, General Surgery MUSC Ethics—Nancy Stout Robinson, Pathology; Sarah Wells, Internal Medicine and Nicole Post, Psychiatry Internal Residency Review—Mary Wren, Pathology; Kwaku Obeng, Radiology and John Watkins, Radiation Oncology Medical Executive—Rebecca Payne, Psychiatry; Jean Ruddy, General Surgery and Deborah Spencer, Pathology Hospital Infection Control—Ben Harvard, Pathology and Eli Penn, Internal Medicine Pharmacy and Therapeutics—Mary Beth Alvarez, Med/Psych and Eli Penn, Internal Medicine Graduate Medical Education Committee—Laurel Bailey, Internal Medicine; D. Tyler Zapton, Radiology; Anne Bartlett, Pathology; Amol Yajnik, Pediatrics; Eli Penn, Internal Medicine; Kwaku Obeng, Radiology and Dobrinka Dimitrova, Radiology Quality Council—Craig Blum, General Surgery; Linsheng Zhang, Pathology; Eli Penn, Internal Medicine and Daniel Nissman, Radiology Medical Records—Courtney Cave, Internal Medicine and Tyler Zapton, Radiology     Friday, July 18, 2008 Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Island Publications at 849-1778, ext. 201.