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.