Have I ever found it challenging to work with certain surgeons? Of course. But luckily, at the environment I'm in, this is a rarity. Culture and environment vary from institution to institution, modulated by the department's leadership, existing physicians, and newcomers. We all play a part in cultivating a teamwork-oriented, blame-free, respectful group that focuses on what's right for the patient.
What I've found is that obvious things are important: you should know the name of the others on the team. When the surgeon doesn't know who I am, it makes our relationship a little more tenuous. Ego is destructive. Surgeons and anesthesiologists need to be confident of their skills, but if ego takes over, disagreements and conflicts can escalate without attending to what's best for the patient. And while it's hard to train attributes like patience, we have to remind each other what's right when tempers flare and emotions heighten.
To work on all this, the residency program incorporates simulation, discussion, feedback, teaching, and rolemodeling. In a recent simulation exercise, the scenario involved a disagreement in management between the mock surgeon and the anesthesiologist. During the debriefing, we examined different ways of approaching the conflict, making ourselves heard, compromising, and de-escalating. Education, especially in residency, is paramount to shaping our future interactions with our colleagues. All that being said, I'm close friends with a lot of surgeons, and I really respect what they do.
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3 comments:
Hi Dr. Chen,
Thanks, I've just read your (thus far) three part series on Working with Surgeons! Very insightful, and very helpful to aspiring anesthesiologists, I think. Thanks so much for writing it (and, if it's alright for me to say, I'm pleasantly surprised you decided to answer my question with a series of posts, and immensely appreciate it)! Thanks again! :)
It sounds like your residency is really excellent like in doing mock simulations to better improve working relationships with surgeons. But, sadly, not everyone is so fortunate. I guess if someone is in a residency where this sort of thing doesn't happen (and this is a little fear of mine, to be honest, if I match into a program like that someday), then I guess the best thing to do is to just try to endure the 3-4 years and hope things are better in the private world?
Thanks for the comment! Although I am sure this varies from setting to setting, I've found that as anesthesiologists progress from medical student to resident to attending, the relationship with the surgeons becomes more collegial and equal.
Granted, there will always be surgeons (or anesthesiologists or nurses or consultants) who are difficult to work with, if you find yourself frustrated or struggling with someone else, discuss it with your superiors, colleagues, and peers. It's something that should be a problem of the past. If you're a in a residency program that doesn't address issues like this, if its important enough, make it happen. Our simulation exercises were actually initiated by a faculty and resident a few years ago to address "nonmedical" issues like this.
Craig
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