Difficult Doctors!!

June 28, 2012

For if you love those who love you, what reward do you have? Do not even the tax collectors do the same?

Matthew 5:46

Hi everyone.  Again, it has been awhile since my last post in April.  As usual, things have been moving pretty swiftly.

I am currently rotating in surgery, which is quite interesting.  Sadly, my time in England is more than halfway done.   After surgery, I have only three more rotations left: Pediatrics, OBGYN and lastly, Psychiatry.

On another note, I am happy to learn today that the Supreme Court approved Obama’s health care bill.  I’m excited and anxious (as is the rest of America) to see how this will shape health care in the future, something we as health care professionals are intimately involved in.

The next series of posts will consist of three topics that I’ve already encountered in my five months on the ward, and which I am pretty confident that you all will encounter as well.

I do not have all the answers in how to deal with them.  In fact, an excellent discussion on the subject could certainly shed light for us all.

The three topics I want to discuss in the series are:

Difficult doctors. Difficult colleagues. Difficult patients.

All of these three are inevitable.  As a student, difficult doctors and colleagues (other students) are separate entities, however, as a doc, they are one and the same.

To begin, we all know that every profession in the world has their share of negative and adverse people that are undesirable to work with. Medicine is no exception.  In fact, due to the high level of stress doctors are under, medicine is especially doomed to have a few doctors whose company leaves a lot to be desired.  Fortunately, in my experience, they are the exception.

Unfortunately, I have personally encountered such company.  This was in none other than surgery, a specialty well known to have its share of grouches.

I scrubbed in for a circumcision of an older man.  Unlike in the United States, circumcision of infants is not common practice, unless for religious reasons, in Europe.  Therefore, you’ll frequently see older males that come to their urologist uncircumcised.  There has been a ton of research documenting the pros and cons of circumcision verses keeping the foreskin.  It is a matter of personal choice, at this point.

However, one sequelae of being uncircumcised is the higher rate of infection under the foreskin due to poor hygiene (it’s more difficult to clean around the extra skin) that can harden it and make it very difficult to pull back the foreskin over the glans penis.  This condition is called phimosis.  It can be very painful.  The best solution: circumcision.

I scrubbed in on the second circumcision that day, after the consultant was called in because his registrar couldn’t sedate the patient enough to start surgery.  The consultant also didn’t like the way the registrar started the surgery, preferring his own method.  Therefore, the consultant was already irritated before beginning.

I scrubbed in because my colleague almost fainted at the sight of the registrar cutting the foreskin with scissors instead of using a scalpel.  She had to leave.

During the circumcision, which went well, the consultant asked me to cut the thread of a suture.  As I begin to cut, he suddenly asked me to stop.  However, it was too late.  I had already cut the suture.

He was furious and asked me to leave. I was shocked and embarrassed (it was a full room).  I didn’t understand what just happened.  I just did what I was told.

I tore off my surgical gowns and left the surgery table.  To be fair, the surgeon apologized after the surgery,  mentioning something about protecting the patient.  I still don’t understand where I went wrong, but I nodded to be polite.

Again, I have no magic solution in how to deal with difficult doctors, but to be polite, and fight off the urge to cry.  It will happen!

Therefore, always be able to explain and justify your actions.  There will always be differences of opinions, but try to justify your reasoning as best as you can.  Also, if the difficult doctor raises his voice or uses swear words, obviously do NOT conform to the same level.  If in public, it is him/her who will appear the idiot, not you.  Also, never be afraid to report to your superiors if you feel that you are verbally abused.  Just because we all know that difficult doctors exist, doesn’t mean we should accept abuse in the workplace.  You do have rights.

How about you? Have you had any similar experiences with superiors? How did you deal with it?  Any advice will help.