This week, the peer-reviewed journal Family Practice Management published my article, Incivility in Health Care: Strategies for De-escalating Troubling Encounters. The timely article has stirred up a much-needed conversation about what it’s like to practice medicine in environments we don’t trust, whether from a rise in threatening or toxic behaviors, unsafe settings, and/or unresponsive leadership.
It is a confusing time in medicine, and confusion breeds so much that is negative and unproductive. Distrust, disorganization, and the chaos that characterize some medical settings these days contribute to incivility from patients and, at times, from frustrated, burned out, unsupported or abused medical personnel. These trends reflect a need for (1) true leadership, (2) effective communication, (3) vision, and (4) unity, without which strategies will remain incomplete at best, or continue to worsen existing problems via misaligned “solutions” (e.g., ICD-10, MACRA, the mandated over-reliance on inadequate electronic health records, NP diploma mills, patient satisfaction surveys, and more).
Although physicians are well acquainted with this new reality, the public is largely unaware of its impact, and many decision-makers in health administration often compound the problem by (1) not knowing or not trusting the physicians providing care, the ones who risk their medical licenses daily in systems that neither value nor fully support them and (2) not understanding ethical aspects of patient care or the depth of commitment to patients that characterizes most physicians.
All my work on behalf of physicians is meant to unify and empower us to regain our collective voice and reclaim our place in medicine. We must come together like never before, every specialty, all of us working to rebuild trust, remind our patients we are here for them, and steer healthcare back from the hands of opportunists toward the simplicity and centrality of the patient-physician relationship.
I hope my article serves to build bridges of effective communication and more trusting relationships between health system leaders, non-clinical administrators, and the medical professionals providing care in a very tough environment. And as you continue to care for others, remember to be good to yourself!