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Tips For Physicians: Dealing with Difficult Colleagues

Recently I attended a CME course entitled “Dealing with Difficult Colleagues.”  It was part of my medical malpractice company’s risk management series to teach physicians/nurses how to lessen our risk of being sued.

This lecture was given by Linda Worley, MD who is a psychiatry professor at UAMS.  She is a good speaker, easy to understand, engages the crowd, and knows her subject.

My only complaint would be that it focused only the “angry” or “frustrated” physicians who exhibit unprofessional behavior and did not include the ones whom you suspect might be difficult due to impairment (illness, drugs, alcohol).

Difficult colleagues can impact a team (in office, OR, or hospital) by creating low morale, high staff turnover, inefficiency, decreased patient satisfaction, increased risk for poor patient outcomes, and increased risk of litigation.

Here are some of the A-B-C-D strategies given for handling “horizontal” hostility (or hostility handed from one person to another to the next in the team): Read more »

*This blog post was originally published at Suture for a Living*

When Grief Turns Into Rage

Twice in the last few months I have encountered grief as rage. Both were in the setting of the cardiac arrest of individuals who were already very ill. One was aged, with severe, end-stage heart disease. One was of middle age, but with metastatic cancer and on hospice.

In one instance, family members became angry because we did not leave the body in the ER for eight hours so that everyone could come and pay their respects. (Which I always thought was the purpose of a funeral home.) 

In another, a family was angry because we did not allow everyone back into the room during the resuscitation of their cancer-stricken loved one — a resuscitation the family insisted upon, and which required rescinding hospice status. From observing their demeanor, their presence would have caused total chaos. Read more »

*This blog post was originally published at*

How To Make A South African Surgeon Really Angry

In the old days sometimes confrontation was the only way to get things done. But sometimes anger lead one into useless and unnecessary confrontation. I recently spent some time with my old friend, swimmer’s chest and a story came to mind when that swimmer’s chest saved me from my own anger.

We were on call together. Quite early in the day the chemotherapist called me. He had apparently put a patient on the emergency list the previous day for a portacath and the case didn’t get done. This was due to the fact that the emergency list first did critical cases like actively bleeding patients before they did relatively stable patients. Something like a portacath would tend to get shifted down the list and may even stand over to the next day. This is what had happened here. He now wanted me to do the case.

“Sure I’ll do it” I said. “As long as it’s on the list as soon as it comes up I’ll be there.”

“I want it done now!” he retorted. I was not impressed.

“Well phone the anaesthetist on call and motivate for him to move it up the list.” I said helpfully.

“That is not my job! You will do that!”

It was clear we had a communication problem. Whenever I had a telephonic communication problem I would put down the phone and take the effort to go to the relevant person to sort it out face to face. Not only does it help to speak things out in person but the walk usually gave me time to calm down (there was more than enough residual anger in those old days to go around). This is what I did here. I turned to swimmer’s chest and told him to accompany me. Off we set at speed.

We walked into the chemotherapy ward and asked to see the relevant doctor. Soon he was there in front of me. swimmer’s chest hung back. I introduced myself and explained that I was more than willing to do the surgery but I had no control over the order of the list. That was entirely in the hands of the anaesthetists. If he felt the case needed to be done before the other cases on the emergency list then he should phone the anaesthetist and discuss it with him.

“You will phone the anaesthetist yourself and you will do this case right now!” he said.

I could feel my anger slowly turning into fury.

“No! you will!” as I said it I clenched my fists and took a step towards him. Swimmer’s chest realised things were on the verge of going south. He later told me he thought I was going to punch the guy. I denied this, but the thought was going through my mind at the time, I confess.

So my good friend stepped in front of me with his broad chest and nudged me backwards. He then started speaking to the chemo doc in a calm diplomatic voice. He also subtly and slowly (almost so one didn’t notice) ushered the guy further and further away from me. By the end of it we left with the chemo guy feeling that we were there for him and would do all we could. I don’t think he even had an idea of how enraged he had made me.

Walking away swimmer’s chest asked me if I was mad. I had only a few month’s of training left and something stupid like getting into a fight was just about all that could stand in the way of me becoming a surgeon.

Those times in the end brought out the worst in me. By the end of my studies I knew I needed to get away from it all. I had very nearly become something I did not like. After leaving pretoria I gradually rediscovered the true me again. It was still there to my relief.

*This blog post was originally published at other things amanzi*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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