Recently, I received a referral to a cardiac specialist due to an oddity on a test in an annual (or not so annual) physical exam. No problem. I’m getting older. It happens. My PCP thought the specialist would rerun the test and then might do additional testing.
That’s not what happened. The specialist wanted to go directly to an invasive catherization procedure run at a minor hospital that almost no one in the area uses. The procedure represented both risk, and with my insurance, substantial out of pocket costs.
I balked at his recommendation and asked if there weren’t something we should do first before doing that. This doctor never returned my phone calls. I guess it was his way or no way.
My wife got into a fight with a couple of anesthesiologists. When she has surgery, if given full anesthesia, she develops pneumonia. After sufficient experience, she has opted to do her surgeries awake. However, anesthesiologists don’t like that. It costs them money. One tried to cancel one of her surgeries when she refused anesthesia. Another called my wife a liar at a cocktail party, when she said she had a major surgery without anesthesia. That cost me a market research client when I defended her (the egotistical doctor was related to the client). But heck, what’s a husband to do?
Some surgeons do like it when patients are awake. They can interact with the patient during surgery and, in certain situations, that can make their work a lot easier.
Patients should like it, because there is substantial medical risk and costs associated with anesthesia. NIH and the AMA changed guidelines regarding use of anesthesia on colonoscopies years ago. However, many doctors and patients don’t seem to know that anesthesia is no longer required with that procedure. The anesthesia is sometimes more dangerous than the procedure.
This discussion came to mind when I ran across an article on nurse bullying (1). Apparently, some nurses bully their peers and their support staff, and that hurts everyone in a facility including patients. The article focuses on bullying in Operating Rooms; the comments on the article broaden the concern to the full range of medical functions. The comments make sense, unfortunately. If bullying can occur in an OR where there are other people and often cameras present, why would it not occur elsewhere?
Let’s face it. Medical professionals are human. They have egos, can be energetic or lazy, smart or stupid, can do brilliant work, and can make mistakes just like anyone else.
Bullying among medical professionals isn’t a new problem (2, 3). Nor is it unique to the US (4). It is kept under wraps most of the time, but pops up periodically. It will continue to do so until medical and nursing schools start including classes on professional behavior in the workplace and medical people in office, hospitals and clinics stop allowing that behavior to go unchallenged.
Bullying creates a problem with patient care, with the ability of professionals to collaborate on helping the ill. It can create an issue with employee retention. Ultimately, it can increase the cost of care and reduce the rate of successful outcomes.
The next time you are in a hospital or nursing facility and a patient’s call bell seems to ring forever, perhaps the first question to ask is, who’s not being a team player and why?
(1) Punke, Heather, “The Purvasiveness of Nurse Bullying,” Becker’s Hospital Review, 1 Sept. 2016. http://www.beckershospitalreview.com/hospital-management-administration/the-pervasiveness-of-nurse-bullying-7-key-thoughts.html
(2) Chen, Pauline, MD, “The bullying culture of med school,” The New York Times, 9 August 2012. http://well.blogs.nytimes.com/2012/08/09/the-bullying-culture-of-medical-school/?_r=0
(3) “Bullying in Medicine,” Wikipedia, https://en.wikipedia.org/wiki/Bullying_in_medicine
(4) Srivastava, Ranjana, “I wasn’t surprised by Four Corners. Bullying in medicine is as old as the profession,” The Guardian, 25 May 2015. https://www.theguardian.com/commentisfree/2015/may/26/i-wasnt-surprised-by-four-corners-bullying-in-medicine-is-as-old-as-the-profession