Optimizing the interaction between residents and attending physicians

Abstract

We analyze how attending physicians should allocate their time between the residents they supervise and their own responsibilities. Under the assumption that a holding cost is incurred when residents and patients wait for a conference with the attending physician, we show that there are only two policies that could maximize the long-run average reward. Namely, it is optimal for the attending physician to start having consultations with the residents either when the residents can no longer examine new patients or as soon as there is a patient ready for conference. Furthermore, we show that the optimality condition is a simple threshold on the holding cost. We then characterize when each of these policies is profitable and the optimum number of residents (supervised by the attending physician) under each policy. We conclude that if a health care facility operates with the optimal number of residents, the two policies become the same and it is always optimal (and profitable) for the attending physician to start conferences with the residents as soon as there is a patient waiting.