Dealing With The Abusive Nighttime Physician: Rules Of The Road
Picture this scenario. A Napoleon-like 5 foot 2 verbally abusive surgeon enters the reading room. He begins to yell at you for not performing an intussusception reduction the way he likes. Moreover, a team of surgical residents stands right behind him, with each member turning red with embarrassment as he continues with his harangue. His verbal abusiveness becomes more and more aggressive. He uses terms such as “idiot” and “moron” to describe you as you attempt to get a word in edgewise. You feel like you want to strike your fist in his face. Does this situation sound vaguely familiar? How would you deal with this common but unfortunate situation when you are by yourself at nighttime?
First of all, no one should have to contend with harassment such as this. I don’t care if you are a resident, nurse, janitor, or attending. Unfortunately, even though society has finally begun to come to terms with refusing such abusive behavior and isolating these individuals, many hospitals still silently condone it. How and why? Perhaps, the hospital is understaffed and would rather have someone to fill the gaps even though he has an abusive personality. Or, the hospital may hire an inappropriate physician because she has a good reputation and brings large numbers of patients into the system. Regardless, the behavior is unacceptable and needs to be dealt with accordingly. So, let’s go through some of the processes you need to complete in order to prevent this harassment again.
Engage Softly With Team Response
The last thing that you, as a resident, want to do, fight fire with fire. If you continue to raise your voice and tussle with this sort of attending, you are making a containable situation into a nuclear bomb! Instead, what is the appropriate course of action?
You can say to this individual quietly, “I am just trying to help you care for your patients appropriately. We are in this together. I will talk to you again when you speak to me in a professional manner so we can help out your patient together.” Usually, if you maintain a quiet and calm demeanor, the raving physician also begins to calm down as well. At this point, the situation usually de-escalates. Who knows? You may even receive an apology. But, that may or may not be the case.
Document, Document, Document
So, what next, assuming the situation does not calm down? If the surgeon has been harassing you, it is most likely an observable long-standing pattern of inappropriate behavior. And, this physician has likely affected many other employees within the hospital as well. Therefore, you should document the behavior in a written form. State the time, place, and situation as objectively as you can. Then, place the document on the side for further use, if necessary.
Next, you may want to ask other observers, if present, to create a supportive document. This lends credence to your inappropriate interaction. You are better off gathering multiple documents to establish a pattern of behavior.
And finally, for each time you encounter these behaviors with this individual, you create another document. You are basically creating a paper trail that will eventually help to remedy this situation.
Speak To Your Supervisor
As for the next step, you need to contact your residency director or associate residency director first thing in the morning. Speak to them and give them the documentation. If possible, leave the wheeling and dealing in the hands of the local administration. Why? Well, often times, the lowly resident does not have the influence upon human resources or senior administration like a long-standing faculty member does. And, the administration can turn back the blame on you.
Last Resort- Human Resources
OK. So, your supervisor has not yet settled the situation. Or, maybe she settled it for that one time but the abuse is recurrent. Where do you go next? Sometimes you just have to go right for the horse’s mouth. You may need to talk directly to human resources and hand over the documentation yourself. Usually, this will begin a full investigation into the matter. Of course, hopefully, you can avoid this situation. Unfortunately, on occasion, you need to act to protect yourself in this way.
Final Thoughts About The Abusive Physician
We all went to medical school and began our training to become a consummate professional. Along the way, unfortunately, you will encounter abusive physicians that do not follow these rules of professionalism. Often times they have issues of their own. But, that does not excuse the actions of these individuals. We, as clinicians, should act according to the rules of civil behavior. And, if these abusive physicians cannot play by the rules, either they need to change their ways or they should not be able to practice medicine. So, we do a service to all by taking action and not remaining silent.