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
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