Official MAR Role

  1. The MAR is NOT obligated to see/examine each and every admission to medicine before assigning a team.

  2. The MAR can expect to have basic data accurately presented when given an admission: Vital signs, oxygen requirements, CBC, Chemistry, X-ray and EKG findings. The MAR cannot be held responsible if data presented are not accurate.

  3. The MAR should evaluate patients who are unstable (if ICU not already involved) OR if their evaluation will make a difference in determining team assignment. Either the MAR or the 3rd-year ICU resident does ICU consults (unless this is changed in future discussions with the ICU team). The MAR manages ICU "holds" in the ED.

  4. The MAR should request tests/consults IF (and only if) the outcome of such a test or consult would alter the direction of the admission. Other tests/consults, if not leading to a change in service/level of acuity of floor assignment, cannot be expected prior to team assignment. If there is disagreement regarding the need for a test or consult to be done in the ED, it will be resolved in discussion by the ED and on-call Medicine attendings.

  5. As the MAR is the only one to know the censuses of the teams, the assignment of team must go to the MAR. Disagreements between the MAR and the ED staff, if not swiftly resolved, should be brought to the chief resident on call, the 4-12 attending on call, and Dr Wertheim (in that order).

  6. The decision to call in MAR back-up rests with the chief resident on call and/or Dr. Wertheim. If it appears that the volume of work is exceeding the capacity of the MAR, the ED staff should call the chief residents to request they call in backup.