Dialogue Volume 14 Issue 2 2018 - Page 43

PRACTICE PARTNER The Competent Professional embedded in the organization,” Dr. Albu- querque says. Organizations can play their part by doing things like creating clear codes of conduct, embedding civility values, and taking occur- rences of incivility seriously. It starts with the leaders, reminds Dr. Albuquerque. She feels that, as a group, doctors do a fairly good job of managing stress. It comes with the territory. Some people thrive on it. There’s good stress that gets you engaged, she says. What the profession perhaps hasn’t done well enough is reflect on how stress can have a negative impact, and sometimes manifest itself in uncivil behaviour. All of that can end up creating even more anxiety for others, and perhaps ill-mannered behaviour on their own part. Stress and inci- vility can be contagious. “When interactions with people don’t go well, that starts to ferment. Then you hear about disruptive departments where people are fighting,” Dr. Albuquerque says. What kind of culture will continue? Recently, the National Post (February 8, 2018, When Doctors Fight Amongst Themselves) ran a piece exploring what happens when doctors let their anger boil over. The conclusion: patient care is jeopardized. The article said that when doctors bully, intimidate or swear at each other (whether in person or online), patients are the hidden victims. One small town doctor (not identified for fear of repercussions) described a colleague’s intimidating behaviour, and said the reac- tion was to “tread lightly, cower…minimize it, make excuses and carry on, even though it adds to our burden, our mental overload and, again, the culture continues.” Mr. Faulkner urges physicians who witness bad behaviour to not let it go unaddressed. The College has developed a companion document Medical Knowledge Clinical Skill Civility Competence Adapted from Brian Hodges MD to its Physician Behaviour in the Profes- sional Environment policy and urges group practice managers and hospital administrators to become familiar with the recommendations articulated in the Guidebook for Managing Disruptive Physician Behaviour. Such issues go well beyond health-care settings, observes Christine Porath, a Georgetown We need University management profes- to keep the idea of sor and author of the 2016 book being civil at the Mastering Civility: A Manifesto for the Workplace. forefront of being Porath has surveyed thousands a professional. of workers over the past 20 years. That’s a good Writing earlier this year for the Harvard Business Review (January thing for all of us, 2, 2018, Make Civility the Norm on especially patients Your Team), she noted that virtual- ly everyone, 98%, has experienced uncivil behaviour, and the frequency with which they do is increasing. Porath reports that some leading organiza- tions offer civility training. She describes one hospital in Los Angeles that does so. They ISSUE 2, 2018 DIALOGUE 43