“When angry count to ten before you speak. When very angry count to 100.”- Thomas Jefferson
(Or in this case, do not write the blog post on the day you’re angry…sleep on it, then respond. Screen shots are forever.)
I’ll start with my angst:
I am loathe to drive people to this piece published on Slate yesterday because I don’t want it to get hits that it doesn’t deserve.
However, it provides context for my blog post you’re reading, so go there at your own risk. Go there understanding that unprofessional, disrespectful behavior by surgeons is a cornerstone of my scholarly profile because of my work describing the behavior and its associated effects. I’ve shared this work as a visiting professor. I’m vice chair of education and professionalism in our department because I am that passionate about this issue, and I’ve got an amazing team working on taking our department from good to great in this arena.
Ms. Robbins’ piece in Slate, and I infer her book, is predicated on stories about the worst-of-the-worst. The stories shared in Slate? Horrifying, worst-case scenarios told from one perspective only. Please understand that I’m not defending the bad actors- I’m simply reminding all of us that there are two or more sides to each story and that the truth is often somewhere in between. I’m also concerned about the tone her article takes, making it sound like the physicians are coming in to work every day with their goal being to make everyone in their work environment miserable and their jobs harder than they need to be. In my career, I’ve encountered at most a couple of people in whom I have suspected that motivation, and I would argue they have personality disorders. The vast majority of surgeons who are involved with disruptive incidents honestly believe that they are advocating for their patient through their actions. They simply don’t understand the secondary consequences of some ways they choose to act. Gerry Hickson’s program at Vanderbilt very clearly demonstrates that most physicians and surgeons, when alerted to disruptive behaviors, can learn new behaviors if their environment won’t tolerate the dysfunctional ones.
In medicine, as in any profession, there is a small minority of individuals who simply cannot be part of civil society. To paint an entire profession in a way that implies we are workplace terrorists? Unfair, unfounded, and damaging. Ms. Robbins’ implication that the nurses are single-handedly holding together patient care is unrealistic in today’s team-based healthcare environment and her apparent belief that surgeons don’t actually care about their patients is patently false.
I’ve previously written here about if Surgeon = Jerk, and have plenty of anecdotal and empirical evidence that it does not. Pieces like Ms. Robbins’ are a cheap shot, and do nothing to help those of us who are truly trying to align our profession and perceptions of it as being filled with good people. If anything, her premise is destructive to building healthy patient care teams.