Wednesday, July 2, 2008

Only so much niceness to go around

I was explaining to somebody in the non-medical field about how much abuse we received as students, interns and residents from more senior doctors. (I didn't tell her how much abuse I still get as a senior doctor). She said something like, "But I thought all doctors had to be nice!". So I explained the facts of life to her.

Early on in my career I noticed that the doctors whose patients loved them all had one thing in common. Without exception they treated students, junior doctors, nurses and whoever else got in their way like shit. Now there were also doctors that were great to work with. Surprise, surprise they weren't popular with the patients. Some of them were actually not very nice to their patients which I thought was cool at the time.

I can remember doctors ranting, cursing, swearing in the hallway outside a patient's room usually at something I had done or often not done; rant finished we would go into the room and it would be "How are we today Mrs. Smith".

Fact is we all only have a finite supply of niceness which we can chose to spread around where we want. Unfortunately niceness is not something that can be divided, it is more a quantum amount; you can give it all in one direction or the other.

Another factor that has to be considered is the person's life outside of medicine. So you have three groups to be nice to: patients, co-workers and family. Most of us only have 2 quanta of niceness (some of us only have one). If you find a physician who is nice to both patients and staff, it is only a matter of time before he starts looking for cardboard boxes to move out. I had the pleasure of working with an internist who was both nice to patients and to staff. I was perplexed by this until I heard a couple of years later that he had just divorced his wife.

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