Playing well with others

Key Points

In residency, I was somewhat accustomed to being low on the totem pole and an unwilling victim of the occasional attending physician's verbal barrage. Once I graduated and became an attending physician myself, I believed that I had graduated from verbal dress-downs by fellow doctors as well. Time has proven that idea false.

My first surprising encounter came in my second month as an attending. I had submitted an electronic referral to the hospital's dermatologist for evaluation of a chronic rash in a young child. I stared dumbly at the screen the next day when I read his terse reply: "He probably has an allergic syndrome. He does not need an appointment with me." The "referral booked" column was marked "No." "What?" I thought. I had spent time going over the differential diagnosis with the parents, listing the failed treatments that had already been tried, and singing the praises of the dermatologist and benefit of his assistance. Now I was stuck trying to explain why my esteemed colleague refused to see their son.

After the baby's condition was stabilized, I walked over to the phone to give the pediatrician more information, explaining that although the baby was pale, he was doing fine and there was no need for her to rush. She proceeded to scold me loudly for calling her to come in, not giving her adequate information, interrupting her in the middle of clinic, and in general being a wretched physician. As in many situations such as this one, brilliant retorts came to mind...30 minutes later. I attempted to explain myself.

"Listen, I understand that you are busy. The obstetrician called you in, not me. I'm just trying to help you by explaining what's going on." When she finally hung up on me a couple minutes later after more yelling, I burst into tears and hurried to an empty room across the hall.

Although her behavior was enough to hurt my feelings, I was angrier at myself for not yelling back. A labor nurse and a senior colleague both informed me of this physician's notable temper and habit of treating everyone around her as she had treated me. I was torn between calling the pediatrician the next day and calmly explaining how rude she had been and just going to the medical executive committee with a formal complaint (because the pediatrician never came in to evaluate the patient). Undecided about what to do, I did nothing.