Doctors Being Difficult and What Makes a Good Doctor
Just to clarify at the beginning of this post that is going to highlight some problem behaviors of doctors; there are a lot of dedicated, amazing, talented, compassionate, caring and kind doctors out there. Bad medical practitioners, as in all professions, are a minority that tend to give the majority of good doctors both bad press as well as a bad name.
I am going to discuss some experiences of bad doctor behavior. But also look at what makes a good doctor.
As I have said, I started my nurse training many years ago in 1986. Times have changed a lot since then, but some of the more negative behavioral traits of doctors still remain. I trained at Addenbrooke’s in Cambridge, one of the most prestigious teaching hospitals in the UK. This meant that most of the doctors as well as medical students were the ‘cream of the cream’, the top 2% of the population, who not only had made it to medical training, but had made it to Cambridge University too. As you can imagine, there was more than a tad of arrogance at times.
This brings me to my first, as well as often cliched behavior, of bad doctors:
The God Complex and Arrogance Doctors
Let’s take a trip back to Cambridge in 1987, where I found myself on a general surgical ward. When the consultant, Mr. Smith (NB: All names have been changed for obvious reasons) visited the ward, all junior nursing staff had to go into the ward library. Heaven forbid that Mr. Smith should even cast his elevated eye over such lowly creatures.
Furthermore, the sister of the ward would retrieve Mr. Smith’s white medical coat. As well as wait at the door of the unit with it held out in preparation for him to slip an arm into each sleeve and march down the ward, with his minions trailing behind, to begin the infamous ‘ward round‘; whereby medical students, junior doctors and the sister of the ward were humiliated as well as terrorized in equal measure.
As the nervous team approached each patient’s bedside the condition; care and medications would be discussed. The poor patient would be barely be addressed and often talked over; as Mr. Smith barked questions and orders at the team. When each patient had been visited, Mr. Smith would stride off the ward and the whole ordeal was over.
Now, I appreciate that this is an extreme example and a long time ago. Times have moved ahead at quite a pace; and this sort of behavior is no longer acceptable. However, the ‘God Complex‘ that results in arrogant doctors may well still be around.
Where does arrogance in some doctors come from?
Doctors do deserve respect and admiration. Confidence has been identified as a key ingredient to success in the medical profession. It is when confidence crosses over into the realms of arrogance that problems arise, not just for the patients but for the whole team working with the doctor. Why does this happen to some doctors?
- Throughout their medical training; it is stressed that doctors hold a patient’s life in their very hands. Their decisions as well as treatments can literally make the difference between life and death. That is one BIG responsibility.
- Doctor’s have a huge amount of knowledge and skill. Medical training is tough as well as rigorous. Many patients, despite increased personal knowledge due to the internet, still regard their physicians with total awe.
- Compare the job of a surgeon, for example, with that of a mechanic. If a mechanic takes out an engine of a car, replaces it and it still does not work, no real harm done. If a doctor is performing open heart surgery, and makes one wrong move, there are no second chances. It is an awesome job with monumental responsibilities.
#1 ~ Traits of Good Doctors: Confidence NOT Arrogance
In a 2006 study on ideal physician behavior by the Mayo Clinic; confidence was cited as the number one desired trait of doctors. It stands to reason that patients and staff need to trust that the doctor is capable and skilled and can inspire confidence in others.
The majority of doctors are capable and skilled but translating these attributes to behavior; that reassures others of this may be more challenging for some.
I chose to cover arrogance first as this trait impacts a lot of other bad behaviors that patients as well as staff alike find upsetting.
Not having empathy, respect or being humane
To illustrate my next point, yet again we head off down memory lane to a busy maternity unit in my nurse training days.
Picture the scene, a woman cradles her newborn baby girl in her arms, tears of joy in her eyes as she gazes adorably at her perfect little bundle.
The mother was in theater having just undergone a cesarean section under an epidural anesthetic to deliver this baby into the world. The consultant surgeon, a man notorious at the hospital for his rather blunt manner, steps up to the bedside and announces,
“That will be your last baby ~ you’re full of adhesions!”
The woman’s face drops and she bursts into tears. Now adhesions, or scar tissue, may pose a problem for subsequent pregnancies after cesarean sections but there are ways and ways of breaking bad news.
This particular surgeon regularly left a trail of crying patients as well as staff in his wake due to his insensitive and rather brutal personal manner.
#2 ~ Traits of Good Doctors: Having Empathy
The above example of how not to break bad news , demonstrates a total lack of empathy, both for the new mother and also for the situation. The mum should have been allowed to get to know her baby, as well as savor the moment, after nine long months of pregnancy. It does not show much courtesy towards fellow staff either as it is invariably the nurses who are left trying to pick up the emotional pieces.
The possibility of subsequent pregnancies was a subject that should have been discussed just before discharge when the mum has recovered from major surgery, not just after the wound had been closed.
Empathy has been defined as:
‘The ability to understand and share the feelings of others.’
This consultant surgeon was speaking only from a medical perspective regarding the scar tissue in the abdomen. This does not bode well either for the new mum’s post-operative recovery. According to a 2012 study by Sarinopoulos (et al.) pain was reduced in patient’s; whose doctors had demonstrated empathy.
#3 ~ Traits of Good Doctors: Being Respectful and Humane
Being respectful towards patients entails addressing them correctly and courteously, listening to their cares and concerns and putting aside all biases towards ethnicity, age, education as well as personality.
One recent study from the Baltimore John Hopkins School of Medicine in the US discovered that doctors are actually nicer to thin patients. The study showed that actual treatment and care were equal, but there was a marked difference in rapport and attitude between overweight patients and doctors. Doctors had much less of an emotional rapport with overweight patients.
Obviously, with doctors as busy and pressurized as they often are in a hospital setting a lengthy conversation is not always practical. Some doctors may appear detached and uncaring. This is because they are in a hurry. However, taking a few minutes to communicate and listen to a patient at the beginning of an encounter, can make all the difference.
Being respectful and humane involves showing care and compassion to the patient. The long list of derogatory acronyms actually used by doctors in medical notes, to sum up patients as well as colleagues, although quite amusing at times, shows a complete lack of respect. This practice is not so common now that patients have access to their notes but it does highlight; a somewhat judgmental, sexist as well as a disrespectful attitude.
Here are a few classics:
- GLM: Good Looking Mum
- GLL: Great Looking Legs
- FLK: Funny Looking Kid
- TBP: Total Bloody Pain
- CLL: Complete Low Life
- FOS: Full of Shit
- GOK: God only Knows
- UBI: Unexplained Beer Injury
- Freud Squad: Psychiatrists
- Slashers: Surgeons
So here ends our post on difficult doctors. There are many other behaviors that can cause problems in the workplace. How to deal with and report difficult or incompetent staff, both doctors as well as nurses, will be covered in another post entitled Whistle blowing.