More Letters to the Editor Edition
Jarrod Shapiro, DPM
PRESENT Practice Perfect Editor
Joined Mountain View
Medical & Surgical Associates
of Madras, Oregon July 2008 |
appy Easter and Passover to all. Our conversations about various topics such as medical classicism and universal healthcare continue. This week I’m leaving it up to you to do the talking. The collective wisdom, experience, and opinions expressed below are what make Practice Perfect a strong tool in our ever-changing healthcare industry. Write in with your thoughts and opinions – be part of the conversation.
***The Classes***
Your column brings to light several issues. I agree with most: staff: holds doctors on some sort of pedestal that I am not sure we mean to stand on, residents hold us to a higher standard and see us on a different plane, even some patients have a hard time relating to us and our lives.
But through the years as I have pondered being "different" or "separate", I can sort of see why that has to happen. Unbelievably I heard yesterday of the firing of two doctors (we have 720 in our large, multi-specialty group) for being ugly and unprofessional with staff. As a doctor, you certainly cannot surround yourself with staff, many of whom have had a fraction of the education and perhaps a completely different upbringing and lifestyle, with whom you share the same work ethic and knowledge base. Becoming frustrated with that situation and you'll go out of your mind. I don't agree with encouraging staff to address you by your first name in the work place in any situation. Years ago my Mother told me her new, very young pastor at my home church wanted everyone to address him as "Bro Chuck", and she simply felt that was inappropriate and she would go right on calling him "Pastor Smith". Staff does not address you as "doctor" because you demand this, they do it out of respect for your skill and dedication. You need to let them do this for them and how they feel working with such a professional and respected member of the community. They are "proud" to refer to you as "doctor", knowing they help you accomplish your goals. Someone once told me to never "discount" your services because that "devalued" your work--what you do for a rich person is the same excellent work you do for a poor person. Nothing makes a person of limited means prouder than to gradually pay a little bit every month to satisfy a medical bill. That person really wants to pay you for your work to heal them, they just may need more time to do it.
The same goes with residents and their relationship with attendings. When I first started here, back into the realm of academic medicine at a large teaching hospital, I tried to be a good teacher and a good friend to these young doctors. I soon found myself taken advantage of by several residents, and when they needed to be reprimanded, it didn't go so well. I had inadvertently undermined my own authority. I sat one resident in my office and read him the riot act for his bad attitude, and after he wiped away the tears , he ran to the GME office and filed a complaint that I had been "unnecessarily harsh" and that he had "never been talked to like that before". Of course, his actions reiterated my feeling that some of these young doctors have never faced adversity (one of the other attendings said some of them act as if they had never been spanked as a child). I have learned from that experience that they don't need nor want my friendship, they want me to be separate and distinct from their world. My wife always asks me what my residency director and mentor would have done to me if I had acted like some of our residents act, and my reply is always, "I have no idea--I would have been too afraid to find out!".
As much as I hate getting older, I have come to understand the way respect works in the workplace and why certain "rules" need to be in place. They are not as important to you because of where you are as a doctor, but more for the people around you who look up to you, ask you for guidance, and for whom you take the responsibility of employing. It is your name stenciled on the front door...... :)
Sincerely,
—J. Marshall Devall, DPM
Assistant Professor,
Department of Surgery,
Division of Podiatry,
Scott & White Memorial Hospital and
Texas A&M Health Science Center College of Medicine
Santa Fe Podiatry Clinic
600 South 25th Street
Temple, Texas 76504
https://podiatry.sw.org
I loved your commentary on the grouping system. I have had such an opposite experience with my workers, attendings, other doctors, etc. I regularly sit down to lunch with my assistants. I would feel very sad to know that they felt uncomfortable hanging out with me at lunch. We've gotten extra busy at work lately and I really miss that somewhat leisurely lunch time. My attendings were terrific. I called them all by first name. That's just the way this program was run (thank you Ron, Rod, Dan, Dave, Jerry,Ed, and Mickey). Other residents in this same residency feel like family. When we get together somehow it's like we know each other very well, even if we
just met. The doctors at my hospital are very easy to talk to. I don't feel at all uneasy making small talk with the cardiologist, the neurosurgeon, or the internist. Look, we all have the same worries and concerns basically, whether we are the podiatrist, trauma surgeon, or the medical assistant. We have our kids, spouses, places of worship, hobbies. We don't keep up with our friends as much as we'd like because we are consumed with our jobs.
Keep up the good work. This is a terrific profession!
—Shari Kaminsky DPM
[email protected]
***Universal Healthcare***
Politics and Health is a necessary mix but policy in the end must be based on need, economy and how it is funded. To have a system based purely on a political point of view is fatal. The world has a litany of those kinds of outcomes.
In the end you can please some of the people some of the time, but not all of the people all of the time.
Cheers and good luck with it all. I am enjoying the banter.
—Casper Ozinga, C. Ped (Au), C. Ped, (USA)
Certified Pedorthist
Comfort and Fit Australia Pty Ltd
1/81 Darley Street
Mona Vale NSW 2103
Australia
www.comfortandfit.com.au
I guess I'm in the minority with you in that I realize that some type of universal healthcare is needed and long overdue. It's shameful to see so many people who are turned away from treatment they need b/c they don't have insurance.
I have to say that it also pains me to see so many who take advantage of the system. These are the people who claim a disability and then live off of Medicare for the rest of their lives. It aggravates me that some doctors let this happen. When I first started practicing, I had an 18 y/o boy come in and say he wanted permanent disability because he had flat feet. Fortunately, he wasn't bright enough to claim that his feet hurt, and told me up front that he had no pain or disability. Obviously I didn't give him the disability. Since then I've seen a number of people who are very capable of working come in with such "disability" income. I currently have a patient who has Medicaid. They do pay for the services he needs at the moment. We've set up referrals and had Medicaid transportation come to his door. He's missed every appointment and "overslept" a couple of times, missing the transportation that tax payers sent to his house to pick him up. This is money that could be used for someone who needs and appreciates it.
It's such a complex issue and I don't know the answer. I know that my husband breaks his back in his current job, which over works him, just so we can keep our health insurance. Something's got to give.
Thanks for the posts!
—Carla Porter, DPM
[email protected]
Keep writing in with your thoughts and comments...we'll see you next week. Best wishes!
Jarrod Shapiro, DPM
PRESENT New Docs Editor
[email protected]
Practice Perfect Lecture of the Week
Kicking off this new lecture series, that will now appear following each Practice Perfect article, esteemed colleague, Marsha Neumyer, BS, RVT, FSVU, FSDMS, FAIUM, shares her vascular expertise in the lecture, Noninvasive Extremity Arterial Studies: What the Physician Needs to Know. |
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