Unmask a Demon

By Jeanette Wolfe, MD

Today identify a person with whom you have had previous challenging interactions and commit to changing your pattern of communication. Not only will this likely help to enhance patient care but it will also likely improve your job satisfaction.

After you pick someone, take a moment to consciously identify that person’s attributes, job requirements and potential stressors.  In doing this, you’ll might discover both similar and quite dissimilar challenges. Often times the real root of perceived conflict may actually be a system issue (a consulting team is short staffed) or simply the individual’s maladaptive attempt to solider through their own nightmare of divorce or family illness. Importantly, you are not being asked to condone totally inappropriate behavior but rather to have compassion for that individual as another human being who is trying to do a difficult job.  Sometimes our perceived slights are just collateral fallout from these other stressors and may not even fully register on our offender’s radar.

Next, identify a low stress opportunity to privately talk to the person face to face. Prepare by word-smithing and rehearsing your approach and consciously avoiding character slams. Consider this outline: validate challenges, identify shared goals, describe objective problem behavior and engage to discover possible solutions.

Here is an example: “ John, (using first name if professionally appropriate), I know that we are both overworked and have a lot of responsibilities and I know that we both want to do what is right for our patients. I’ve recently noticed some challenges concerning dispositions in some ED consults. Is there a way in the future that we could touch base about your recommendations before you leave the department to help avoid potential confusion and patient care delays?”

These discussions may ultimately reframe understanding and provide simple solutions (like ensuring that John has access to your number so that he isn’t late for his next case). But even more importantly, these difficult conversations are often the first step in bridging long standing institutional gaps and jump-starting better habits that is simply good medicine for everyone.

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