Two Strategies for Bringing Respect into Working Relationships

Jennifer, a family physician in a large city, felt frustrated by her colleagues’ lack of respect. Once again she was enduring the slow grind of specialist referrals. To her distress and despair, the process was becoming an established part of making a referral.

Step 1, she phones a specialist’s office to indicate that she wishes to refer a patient wish a condition requiring urgent attention. She requests that the specialist return her call to confirm acceptance of the referral and to exchange important information about the case. Step 2, nothing happens. Step 3 to X, she makes additional calls making the same request. After entirely too many calls, the specialist returns the call with no apology or any indication that anything is out of line.

This pattern creates problems for Jennifer.

  • First, it increases her workload unnecessarily: she must make more phone calls; one should suffice.
  • Second, it lowers her esteem in the eyes of her patients. Rather than taking quick, definitive action during their time of distress, she is resigned to counsel patience while awaiting a phone call.
  • Third, the process conveys disrespect of her by from specialist colleagues. In fact, she’s not sure they actually consider her and others in general practice as colleagues.

Jennifer has a limited perspective on these interactions. She experiences them as a family doctor who has a defined role of mediating between the needs of patients and the refined services available from specialists. Her work of triaging patients’ complaints to channel them appropriately increases the time they can dedicate to applying their skills. Jennifer is not seeking a major celebration of her role in the system, but she does believe that she deserves basic civility in her encounters with medical colleagues.

What to do?

Jennifer can improve collegiality on two levels. Person-to-person, she can deepen her involvement in networks among her medical colleagues. By establishing more intensive relationships with specialists in her area, she would increase the extent to which specialists would consider her requests to be compelling. A request from a friend is more compelling.

Secondly, she could increase her involvement in professional organizations. Collegial organizations provide a platform for talking through problems in coordination and relationship management.

A central point is that people can shape their relationships through thoughtful, deliberate action. It’s not necessary to endure others’ disrespect and it’s futile to wait for them to recognize the error of their ways. Focused action can create respect where it is lacking.


  1. I do sympathise with Dr. Jennifer’s predicament; but must confess that in third world countries there is exactly the opposite problem. In fact often there is an evil collusion/nexus between GPs and specialists on the one hand; and medical practitioners and pathological labs on the other. Patients are needlessly referred to specialists and asked to undergo pathological investigations, of course, at considerable costs to them. In third world countries specialists and path. labs are not averse to even shelling out “kick-backs” to GPs just to get them to refer patients to them. It does take all kinds to make the world.

  2. Seth
    Thanks for your insight on this issue. I agree that medical practice can have many convoluted processes. I think an important point here is that when individuals feel excluded from the process, it feels like disrespect. Ideally the system that evolves will work both for the professionals and for the patients.

    I’m pretty sure no system is foolproof, making it necessary for direct interaction among individuals to bring things into line so it works better all around.


  3. Gday, Just wanted to show you that your web site isn’t launching properly on my apple iphone. Have you any idea if there may be some setting I have to use to make it display properly? Almost everything is out of line.

  4. Hi
    I’m sorry to hear the site isn’t showing up on your iphone properly. I just checked mine and it looked fine. Either orientation was right on for the central text and the columns. We’ll look into it and I hope we can find a way to help you with seeing it. Communication is tough enough without displays failing to line up.
    All the best,

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