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	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

With reference to the excellent article by Kearns et al¹ in the January 22, 2001, issue of the ARCHIVES, the absence of differences in length of stay, outcome, and utilization of resources comes as a welcome reinforcement for the job done by attending physicians who supervise patient care for only a few months each year. It dampens somewhat the enthusiasm for the purported greater efficiency and quality of hospital-based physicians who attend 10 months per year.

Not mentioned in the article is the role of house staff in smoothing out the results. Duration of stay, requests for laboratory results, and adherence to guidelines for care are routinely in the hands of the ward residents in university-affiliated hospitals such as Santa Clara Valley Medical Center, San Jose, Calif, and the University of California in San Francisco. As long as there is no marked deviation from norms, there is usually very little . . . [Full Text of this Article]

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