“Patient care suffers when doctors can’t get along. It’s time to shine a light on the distressing effects of doctors behaving badly”. One of her psychiatrist colleagues has observed that a common reason why doctors see her is to figure out how to coexist peacefully with other doctors.
Do doctors argue, fuss and fight? Do they have trouble working with each other in genuine collaboration? Absolutely. The medical profession as a whole abounds with fragile egos and deep vulnerabilities. But does it affect patient care? You bet – in obvious ways when we disagree on a plan, say surgery versus no surgery, antibiotics versus no antibiotics, but in far more subtle ways when by choosing expediency over healthy debate doctors go along with what other doctors want. This is how many patients end up having expensive and duplicated tests and dubious interventions. In this age of piecemeal medicine, frankly it is easier to let each doctor have his or her own “right of way” with the patient even though it doesn’t feel right and is not right….
Extreme cases of doctors behaving badly are reported but the majority of every day incidents are not. The truth is, no doctor would dream of it – there is an extraordinarily high level of reticence among doctors to be seen as “precious”. Research, here and abroad, points to increasing levels of anxiety, depression and burnout among doctors. We traditionally invoke factors such as long hours, demanding patients and unending bureaucracy as the cause but perhaps it is worth asking what role doctors play in harming each other, however unintentionally.
Medical training would benefit from acknowledging this at an early stage and focusing on practical ways of not just resolving conflict but crucially, on avoiding it. Who knows, we might find that a course on How To be Nice to Your Fellow Doctor would ultimately rain benefit on the now ubiquitous course on How to be Nice to Your Patient. ”
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