Thursday, July 21, 2011

Barbers of Civility

Updated 3/2017-- all links (except to my own posts) removed as many no longer active. 

It seems to me this topic of surgeon and their lack of civility gets pulled out ever on a fairly regular basis.  This latest discussion in the news media is due to a short article in the current Archives of Surgery (full reference below).
Surgeons as a group have a reputation (which even nice ones have trouble overcoming) of arrogance and incivility. 
The authors, Klein and Forni, of this article state (bold emphasis is mine):
Uncivil behavior is so present in society at large that we should not be surprised to find it among health care workers. This article is meant to raise the awareness of the costs—both in dollars and in human misery—of incivility in the practice of medicine by looking in particular at the case of surgeons.
Uncivil behavior brings misery wherever it occurs.  If the individual tends to behave in an uncivil fashion prior to medical school and prior to residency, then that individual is likely to behave in an uncivil behavior in practice.  Medical school and residency aren’t “finishing schools” in that regard.
Medical schools seem to have become aware of this simple fact.  Recent news articles report some medical schools will begin interviewing for “people skills” in their applicants --  NY Times article by Gardiner Harris: New for Aspiring Doctors, the People Skills Test.
I applaud Klein and Forni for their suggestions that surgeons lead the civility imitative in health care: 
The surgical community has an incredible opportunity to lead a civility initiative in health care. The first step is to recognize the power that civility has to improve the surgical workplace, the patient outcomes, and the workers' quality of life. Organizations should commit to developing a universal code of conduct that is identical for surgeons, nurses, staff, administrators, and patients. This code must have clearly defined expectations as well as consequences for violations. More important, the code should be applied fairly and consistently, without modification or special allowances based on an individual's actual or perceived status in the group.  ………

“I’ve learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.”   --Maya Angelou
My past article on the topic
Behavior of Surgeons  (July 24, 2008)
A Surgeon's Outburst  (August 13, 2008)
Consultations  (May 24, 2010)
Tips on Dealing with Difficult Colleagues (May 9, 2011)

Barbers of Civility; Andrew S. Klein; Pier M. Forni; Arch Surg. 2011;146(7):774-777; doi:10.1001/archsurg.2011.150

1 comment:

Mal Content said...

Its so difficult sometimes...and its often contextual...working in the Trauma Unit at the Johannesburg Hospital- (which was essentially one large Resus Room)-,which only saw patients with life threatening injuries,it was difficult to be civil to some admin colleagues and occasionally to the patients on whom you were attempting to perform some gross and painful and invasive procedure.
We were generally not uncivil to each other due to the nature of the work and the high morale and good ethos of the Unit
When we would fly somewhere to provide care,particularly on inter-hospital transfers,it was often difficult to get the local staff and family to understand the urgency of the situation and the scope of what we needed to do.
nevertheless I think there were always instances particularly those involving children which made you reflect on your manner.
indeed we were one of the first hospitals in the world I believe to bring family members into the Resus Room whilst still actively working on their children...this was in 1987.
I find it more difficult now to be honest when I am essentially working as a GP to be civil to patients who think that the hospital is a health supermarket!