What is happening to physician camaraderie and collegiality? Are the days of being a “team player” as a practicing physician over? Are all the cutthroat premeds now becoming cutthroat physicians?
Physicians are honorable people. Most of us have pursued doctor jobs to provide the ultimate service for others. We have committed over a decade of our lives to intense study, training, sacrifice, debt, sleeplessness, stress, and physical and mental exhaustion to do whatever it takes to help our patients recover from debilitating diseases. However, we are only human. No matter how self-sacrificing and empathetic most physicians are…once in a while, our egos get the best of us. If we start letting self-interest motivate us at the expense of patient care and collegiality, the profession of medicine will fall apart at the seams.
How can we have each others backs? There are many concrete ways for all of us to become better colleagues and ultimately safeguard the future for all physicians in our country.
The 25 Golden Rules of Physician Collegiality
1. Work as a team to negotiate with hospitals and insurance companies. When you accept payment of pennies for your work by signing ridiculous contracts, you are ruining it for everyone else. Don’t be the one doctor who will accept payment of $12 for an office visit when all your colleagues won’t.
2. When patients come to you for a second opinion, don’t mock or discredit the work of your physician colleagues. Be realistic and positive with the patient: “This complication can happen and is one of the risks of surgery. Now let’s see what we can do to fix this.”
3. If you signed up to be teaching faculty, then you are there to teach. Scutting out, criticizing, and/or mocking fellows, residents, and interns without offering them any constructive teaching is simply a selfish abuse of power.
4. DO NOT LOWBALL PRICES FOR BUSINESS!! Don’t lowball the market price of elective procedures. For example, don’t charge for Botox injections at cost for the sake of acquiring a new patient. This is how you devalue your services and, ultimately, set a new lower standard for the services of your colleagues.
5. Proctor your colleagues at surgicenters and hospitals when they ask. You can actually learn from working with newcomers.
6. Avoid becoming a whistleblower. Don’t report colleagues to the medical board or the hospital board unless they are a true and imminent danger to patient safety.
7. Be available for your referring docs’ emergencies. If a doctor is referring patients to you, don’t abandon them when they call you with an emergency.
8. Write a note or call your referring doctors after seeing their patients. It’s common courtesy.
9. Be generous in offering discounts to your physician colleagues for their own medical care.
10. Be generous in switching call coverage if your colleague is in a bind.
11. Don’t badmouth other doctors in front of patients.
12. Don’t badmouth other doctors in front of other doctors.
13. Don’t tell patients that their referring doctor misdiagnosed or mismanaged their case. You are being referred the patient for your expertise, not for your criticism.
14. Help your colleagues learn new techniques and procedures if they ask.
15. If a patient of a colleague wants to transfer his/her care to you, strongly discourage it.
16. Don’t badmouth a colleague in order to suck up to administrators and other people in positions of power.
17. Cover your colleagues when they go on vacation or are on leave for illness, and be careful not to steal patients while they are away.
18. When you cover on-call duties for your colleagues, do a solid job. Don’t be lazy. Go in and see patients who have legitimate emergencies.
19. Praise your physician colleagues for a job well done. It shows humility and patients respect you more for it.
20. If a patient is referred to you by his/her primary doctor, don’t refer the patient to other specialists without first discussing it with the patient’s PMD.
21. Give your personal phone number to your colleagues so they can easily reach you with questions.
22. Don’t do tests and procedures on patients if their referring doctor likes to do them himself/herself. Send the patients back to their referring doctor for those tests and procedures.
23. If new doctors come to your office to introduce themselves, welcome them. No matter how busy you are and make a point of getting to know them. See how you can help them build a practice or find top doctor jobs. Pass out their business cards.
24. If a colleague is ill or becomes disabled (or his close family member is dealing with illness), be generous and offer your support. This sounds like a no-brainer, but many physicians get so busy managing patients, they can neglect their colleagues who are struggling with significant health challenges.
25. The Ultimate Sin: Don’t get a JD, in addition to your MD, so you can become a malpractice attorney who sues physician colleagues and leaves them hanging out to dry!
How many of these golden rules of collegiality have you violated in your medical practice? If you want to maintain the dignity of the profession of medicine, always remember the following core principal:
“The true character of physicians is not simply defined by how well we take care of our patients. It is equally shaped by how well we take care of our colleagues.”
Dr. Abe Kashani