Dr. Nightmare

Dealing with difficult physicians

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Ben Roberts, RT(T)

When you find yourself working with a difficult physician, there are ways to improve your working relationship that don't involve childish pranks. Workplace friction is best dealt with before it grates away at productivity. Here are some practical tips to help you deal with a difficult physician.

It may sound like something out of a fortune cookie, but it's true: The first step toward resolving conflict begins with you. You have to change your own attitude before you can tackle everybody else's problems. Everybody has off days. Understanding your own attitude when feeling stressed or helpless grants you sympathy for your coworkers when they're also having a bad day.

The same is true when you relate with physicians. According to Jennifer King, a psychologist and director of Bristol, United Kingdom-based Edgecumbe Consulting Group, "If we take the view that many difficult doctors are really doctors in difficulty, we are likely to approach the problem more constructively and with a better chance of success." The goal is not to prove who is right and who is wrong; the goal is to reorganize the work environment to create less friction.

Another necessary survival skill is professionalism. "Professionalism" is more than just a two-bit word thrown around at resume-writing classes. It is essential to smoothing out workplace friction. Professionals believe they're not just doing their job – they're changing the world, one life at a time.

Proactive thinking is key to professionalism. Anticipating problems and making changes should be a priority anytime you're working with the difficult physician.

This could be a range of simple acts, from not chewing gum when talking to the physician to conducting research on a patient's condition before approaching the physician with questions about protocol. Radiologists require concentration to make diagnoses that can drastically alter a patient's life. If you're going to break their concentration, do it for a good reason and have your facts straight first.

Next, listen up. Listening for the meaning behind what people say is like a puzzle game. For example, when the physician says, "All of these exams look terrible," if you only listen to the words, you are liable to respond defensively. But, if you pay attention to the level of the physician's feelings, you might hear "I am stressed out and frustrated." Then, if you take the listening to the next level and put together the puzzle pieces of meaning, you might hear "I am having a difficult time making a diagnosis from these images." Responding to the physician on this level of meaning allows you to escape defensive behavior – and even anger – and helps you sympathize with the physician and respond by asking, "What can we do to help your diagnosis?"

You should also be assertive. Assertiveness is the fine art of confronting a problem without appearing confrontational. The first rule of assertiveness is to use your words, not your tone of voice, to express your message. In other words, do not sound angry or annoyed as you assert your point. Say it in the same flat tone of voice you might say, "Will you pass the butter?"

Use "I" language to assert yourself in your message. For example, "I feel nervous when you raise your voice." This message forces the receiver to realize that you're a person with dignity and deserving of the physician's respect. It also puts the focus on the behavior, not the person, which is crucial to encouraging change.

Your message must make it clear that you believe the physician is capable of changing. So, if you are put in an aggressive situation, respond by attacking the physician's behavior, not his or her character.

You can also make simple changes to improve your work environment. Reduce clutter and potential for noise as much as possible. If appropriate, play music in your work area and post cartoons on the bulletin boards. Give the phone a pleasing ring, adjust the lighting to prevent headaches from eyestrain and provide cold spring drinking water. These suggestions are common sense, but they make a difference in employee satisfaction.

But sometimes a friendly work environment just isn't enough. In this case, it may be necessary to have a formal discussion, or even an intervention, with the difficult physician. If intervention is necessary, consult with a social worker or behavioral health specialist about ways to approach a problem without making the guilty party go on the defensive. And remember, compromise is imperative.

Resolving grudges is not an easy task and may require innovative thinking. Don't be afraid to experiment with solutions, but keep in mind the basic tenets of diagnostic medicine: An imaging department is a team working to aid the patient.

But if the difficult physician still continues to complain, try to view his complaints as places for improvement. Set goals, try to fix the problems and track your changes. Then be prepared to say, "Last month, we were told this protocol was sub-par. So, we made some changes and here are the results."

Also, learning about digital photography and computer photo editing is rewarding, especially when you are pasting a picture of the physician's face on a bathing beauty. But, it may be best to save that suggestion for April Fools' Day.

— Ben Roberts, RT(T), is a certified radiation therapist at McKay-Dee Hospital Center in Ogden, Utah, and at the Utah Cancer Specialists in Salt Lake City.