With that context, understand my sincerity in asking “What is it with doctors?”

In my writing and my client work, in- and out-group dynamics come up a lot. Doctors are perceived as a very specific constituency in the system… with good reason. The extent to which this perception stands is fascinating:

At lunch recently with a fellow consultant in the health care system said to me: “We seek to inform the doctors, but all we hope is that they don’t actively resist the work we are doing.” Working with a hospital group recently, the historic specter of the doctor vs. nurse divide reared its head. An academic mentor of mine with whom I consulted before launching my practice suggested: “It won’t work if you don’t get the docs on board, and I don’t think you will.”

There are a number of reasons why doctors could view themselves as very removed from the system: degree of training, stature that crosses most/all cultures, different employment structure with the hospital/community system, etc. But do they see themselves as that different? Some may, some may not.

If I were a doctor, I think that I would be proud of my accomplishments, and I might develop an ego. I also might think that it is my job to make decisions and may actually not appreciate what I perceive as challenges from other staff (RNs, RPNs, etc.) who (although they are only trying to help) are trying to make those decisions for me. What if they are wrong? If I were time starved, as many doctors are, I may not be able to take the time to “soften” my message or think about the “how” of my communication skills.

If doctors are removed from the workings of the system, they can take responsibility to “engage” more. If they don’t those working around them can accept the out-group reality and behave accordingly. The right information to save and prolong lives can still get through. Like many things, it is easiest if both sides work together. Some doctors will; some won’t or can’t. It is the latter group that could tip the scale one way or the other. As some of the tougher reforms come through, it will be interesting to see if the perception (and reality) of doctors change.