By ANN DONAHUE
You're in the hospital, waiting for an exam. In walks your physician, accompanied by 15 fresh-faced Doogie Howser wannabes with stethoscopes and lab coats. Some look like the kids who play Nintendo with your kids.
Welcome to patient care at a teaching hospital, such as the one at UCLA.
After two years in medical school, students are matched up with a seasoned doctor to begin the internship process. This means following doctors on their rounds and helping diagnose patients.
Though disconcerting for some patients, many in the health care field believe this kind of care can be an asset for the seriously ill. Though young, interns are just out of two years of intensive study at medical schools. That means they've had exposure to the newest research studies and promising medical theories.
"Don't think 'Aaack! Little kids are going to be working on me!' " said David Langness, director of communications for health sciences at UCLA. "What some perceive as the biggest disadvantage about teaching hospitals is actually the biggest advantage."
Langness said all interns work directly under the supervision of a more experienced doctor. Diagnoses made by interns have to be run by this supervisor, and the older physician also has to sign off on all of the charts that measure the patient's progress.
"Look at it this way, you've got 15 different perspectives that know more sometimes than the seasoned physicians overseeing them," said Jim Lott, executive vice president of the Healthcare Association of Southern California. "You've got the best of both worlds."
Langness points out that many teaching hospitals have a strong commitment to research, an advantage that doesn't exist at other medical centers. As a result, clinical trials for new medicines are frequently held at teaching hospitals, so patients have more options for treatment if they face a serious illness.
Because of this commitment to research, high-end specialists in a particular medical discipline tend to congregate at teaching hospitals.
"Something like 80 to 85 percent of people who have won the Nobel Prize for medicine are affiliated with teaching hospitals," Langness said. "That's a pretty profound advantage. That's why celebrities and heads of state who can afford to go anywhere come here. Teaching hospitals are where care is optimized in the American health care system."
That's not to shortchange standard hospitals, Lott said, it's just that teaching hospitals have more resources at hand to provide care in extraordinary medical situations.
Being in a research center might make some patients feel like guinea pigs but it can also save their lives, Langness said.
UCLA, for example, just completed a clinical trial for Herceptin, a drug that has shown promising results in treating women with a virulent type of breast cancer. As a possible alternative to chemotherapy, Herceptin works to alter the gene that makes women predisposed to contracting the illness. Approval of the drug by the Food and Drug Administration is pending.
"If you go to a university teaching hospital you can get things that are not yet in wide use," Langness said. "Before this drug, these women had a death sentence. They say the impact this has had on (them) has been enormous."
Lott said that if he had a severe medical problem, he would "run, not walk" to the nearest teaching hospital.
Langness said one perceived drawback of university teaching hospitals is size. UCLA has 5,000 employees, and between 5,000 and 10,000 patients are treated at the hospital each day. "They tend to be big, confusing, complex places and it takes some time for people to find their way," Langness said.
On the other hand, as long as a hospital makes you feel better, who cares if it has the feel of a small city? "When you go to a hospital, you go there to get taken care of," Lott said. "You don't go there to socialize."
At a glance
There are four medical schools in the Los Angeles area that have affiliated hospitals: UCLA, USC, Loma Linda University and Charles R. Drew University.
Students at UCLA and Loma Linda can practice at the hospitals directly affiliated with those schools. Drew students intern at the county's Martin Luther King Jr.-Drew Medical Center, while USC medical students work at County-USC Medical Center along with the university's two separate hospitals near the campus.
Veterans' hospitals also double as teaching hospitals. Locally, those include the Veterans Administration medical centers in West L.A. and Long Beach, and the Jerry L. Pettis Memorial Veterans Medical Center in Loma Linda.
In addition, there are several private hospitals that take students from around the area under their wing, including Cedars-Sinai Medical Center, Huntington Memorial Hospital in Pasadena and Long Beach Memorial Medical Center.
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