The DEFINITIVE respect thread

[Hard24Get]

I know, I know, this subject has come up a million times. But even looking at the old threads, I still am not getting it. First of all, let me say that I have been the stereotypical med student who loved everything, and thus has considered just about everything for a specialty. But each group I talk to says they get no respect, including EM. So who gets respect? Please answer the following questions:

1) Does anyone have CONCRETE examples of this so called disrespect and how it affects their ability to practice medicine (besides someone trying to block an admit)?

2) Why do people say to find a hospital where surgery and medicine are not "strong" - Shouldn't EM have its own stuff to do regardless?

3) And what is this not getting to "run" traumas - so what if you have something interesting to do everyday?

4) Surely the respect thing can't just be people from other fields talking behind your back - who cares about that (I'm having visions of 13 year old surgeons following me home from the hospital and calling me "cootie-doc" as tears stream down my face )????

At least laypeople will continue to think we are the most important (and most highly sexed) group in the hospital

Come on, guys, I know the post is long, but let's settle this!

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[8744]

Hi.

When I walk into a rotaton for the first time, I bellow, "I'm Panda Bear. The roughest, toughest, meanest, son-of-a-bitch you will ever meet and as I am an equal opportunity ass-kicker if I get one snide comment, one less-than-respectful remark, I will kick your mother-****ing ass."

Then I drop my pants, display my manhood and say, "If you can't top that, then shut the hell up!"

I'm actually not that big. Average really. Well, within two standard deviations whatever the case. Still, since nobody has the guts to drop their trousers they can protest all they want but I'm the only one flapping in the wind so I win by default.

Respect is earned, never given.

Glad I could help.

 

[Faebinder]

You mean there are actual specialties that get respect from patients? I thought it was a myth of the past. Indeed, perhaps I should show my manhood more often. I think I am with the two standard deviations as well.

 

[EctopicFetus]

I think most patients respect the docs its the docs that dont respect one another..

 

[bulgethetwine]

I know, I know, this subject has come up a million times. But even looking at the old threads, I still am not getting it. First of all, let me say that I have been the stereotypical med student who loved everything, and thus has considered just about everything for a specialty. But each group I talk to says they get no respect, including EM. So who gets respect? Please answer the following questions:

1) Does anyone have CONCRETE examples of this so called disrespect and how it affects their ability to practice medicine (besides someone trying to block an admit)?

2) Why do people say to find a hospital where surgery and medicine are not "strong" - Shouldn't EM have its own stuff to do regardless?

3) And what is this not getting to "run" traumas - so what if you have something interesting to do everyday?

4) Surely the respect thing can't just be people from other fields talking behind your back - who cares about that (I'm having visions of 13 year old surgeons following me home from the hospital and calling me "cootie-doc" as tears stream down my face )????

At least laypeople will continue to think we are the most important (and most highly sexed) group in the hospital

Come on, guys, I know the post is long, but let's settle this!

You won't be respected by some doctors in some specialties, some of the time, no matter what you do. Your day-to-day interactions with other doctors (referrals, consults, discussions in the context of admitting patients) will be governed more by the relative sleep deprivation one or both of you are operating on more than any ill-defined notion of "respect". If you go into ED this is a concern that will never be definitively "settled", and there are no magic words that I can type to soothe concerns over respect (or lack thereof).

I think many EM physicians are thick skinned in the respect sense. This doesn't mean we don't take and consider criticism (that is part of being a profesisonal) and it is incumbent to not act arrogant. But at the end of the day, if I am continuing to learn, enjoying my job, striving to provide excellent care to my patients, and giving respect to every doctor/nurse/tech/cafeteria worker that I interact with, then if someone chooses to treat me with disrespect in return -- say by fighting an admission, or being overly condescending or whatever -- then I have a simple way to deal with it. First, I extend an olive branch. It might be a very calm request to reconsider, it might be an equally calm request to come and see the patient with me. If they still are acting in what I feel is an unprofessional manner (i.e disrespectful) then I don't bother trying to whine and mollycoddle them so they "respect" me more -- I inform them and follow through with documenting our interaction (and the decision that resulted) in the chart and, if need be, I go up the food chain to their next in command. Often times, their tone reverses 180 degrees, or they call back within 30 seconds. Either way, I can still look myself in the mirror, I don't bother wasting a whole lot of time, and the patient gets what they need.

I have to emphasize that this approach only works if you are constantly hypervigilant against being arrogant yourself. It's the only way you can take the high ground when it comes to respect in the hospital.

 

[Hard24Get]

So, basically tensions arise because you work with others alot and people blame it on being an EP doc - that's like saying "it's because I'm black"

I love your tactic, Bulge, and will definitely use it!

You won't be respected by some doctors in some specialties, some of the time, no matter what you do. Your day-to-day interactions with other doctors (referrals, consults, discussions in the context of admitting patients) will be governed more by the relative sleep deprivation one or both of you are operating on more than any ill-defined notion of "respect". If you go into ED this is a concern that will never be definitively "settled", and there are no magic words that I can type to soothe concerns over respect (or lack thereof).

I think many EM physicians are thick skinned in the respect sense. This doesn't mean we don't take and consider criticism (that is part of being a profesisonal) and it is incumbent to not act arrogant. But at the end of the day, if I am continuing to learn, enjoying my job, striving to provide excellent care to my patients, and giving respect to every doctor/nurse/tech/cafeteria worker that I interact with, then if someone chooses to treat me with disrespect in return -- say by fighting an admission, or being overly condescending or whatever -- then I have a simple way to deal with it. First, I extend an olive branch. It might be a very calm request to reconsider, it might be an equally calm request to come and see the patient with me. If they still are acting in what I feel is an unprofessional manner (i.e disrespectful) then I don't bother trying to whine and mollycoddle them so they "respect" me more -- I inform them and follow through with documenting our interaction (and the decision that resulted) in the chart and, if need be, I go up the food chain to their next in command. Often times, their tone reverses 180 degrees, or they call back within 30 seconds. Either way, I can still look myself in the mirror, I don't bother wasting a whole lot of time, and the patient gets what they need.

I have to emphasize that this approach only works if you are constantly hypervigilant against being arrogant yourself. It's the only way you can take the high ground when it comes to respect in the hospital.

 

[a_ditchdoc]

Hi.

When I walk into a rotaton for the first time, I bellow, "I'm Panda Bear. The roughest, toughest, meanest, son-of-a-bitch you will ever meet and as I am an equal opportunity ass-kicker if I get one snide comment, one less-than-respectful remark, I will kick your mother-****ing ass."

Then I drop my pants, display my manhood and say, "If you can't top that, then shut the hell up!"

I'm actually not that big. Average really. Well, within two standard deviations whatever the case. Still, since nobody has the guts to drop their trousers they can protest all they want but I'm the only one flapping in the wind so I win by default.

Respect is earned, never given.

Glad I could help.

**Bows to Panda**

(I think I could top you...but I catch cold easy...)

 

[BKN]

So, basically tensions arise because you work with others alot and people blame it on being an EP doc - that's like saying "it's because I'm black"

I love your tactic, Bulge, and will definitely use it!

A call from the ED at 2 am is never good news. I try to cut them some slack. I try to do anything for their convenience that is safe for the patient. Indeed, my doing those things without waking the consultant and increasing their sleep deficit may be in the interest of my patient and their panel for the next day.

On the the other hand, if someone has been a consistent jerk, I can turn real stupid and needy on their call night.

 

[mikecwru]

You won't be respected by some doctors in some specialties, some of the time, no matter what you do. Your day-to-day interactions with other doctors (referrals, consults, discussions in the context of admitting patients) will be governed more by the relative sleep deprivation one or both of you are operating on more than any ill-defined notion of "respect". If you go into ED this is a concern that will never be definitively "settled", and there are no magic words that I can type to soothe concerns over respect (or lack thereof).

I think many EM physicians are thick skinned in the respect sense. This doesn't mean we don't take and consider criticism (that is part of being a profesisonal) and it is incumbent to not act arrogant. But at the end of the day, if I am continuing to learn, enjoying my job, striving to provide excellent care to my patients, and giving respect to every doctor/nurse/tech/cafeteria worker that I interact with, then if someone chooses to treat me with disrespect in return -- say by fighting an admission, or being overly condescending or whatever -- then I have a simple way to deal with it. First, I extend an olive branch. It might be a very calm request to reconsider, it might be an equally calm request to come and see the patient with me. If they still are acting in what I feel is an unprofessional manner (i.e disrespectful) then I don't bother trying to whine and mollycoddle them so they "respect" me more -- I inform them and follow through with documenting our interaction (and the decision that resulted) in the chart and, if need be, I go up the food chain to their next in command. Often times, their tone reverses 180 degrees, or they call back within 30 seconds. Either way, I can still look myself in the mirror, I don't bother wasting a whole lot of time, and the patient gets what they need.

I have to emphasize that this approach only works if you are constantly hypervigilant against being arrogant yourself. It's the only way you can take the high ground when it comes to respect in the hospital.

You'll always have people make disparaging remarks because it's the easy thing to do, we're the easy one to blame.

I've had all kinds of reactions from tired, overworked, sometimes personality-disordered fellows/residents... people swearing at me, people literally whining (but I don't waaaaaaaaaaaaaant to), and a couple have literally burst out crying.

You give everyone a chance to do the right thing, you try to understand from their perspective, cut them slack when you can, and don't reciprocate the swearing. I agree, if something can't be mutually worked out, you march up the ladder (talk to their chief, attending). That usually solves admission, consult problems when I'm paging the attending at 3:30am.

One of our chair's favorite sayings is that he gives everyone one chance to "do the right thing."

Residents that work at our hospital as part of a multisite residency know we don't "page for everything," like they get at the other hospitals. When ever someone says that, I offer to page them for every abd pain, etc that night. That usually shuts that up.


mike

 

[Doc Brown]

As a corollary to this thread, has anyone made a diagnosis, saved a patient, done a neat dance that got you some love from other services?

 

[ERMudPhud]

As a corollary to this thread, has anyone made a diagnosis, saved a patient, done a neat dance that got you some love from other services?

Where I work we do procedures, mostly lines and intubations, for many of the hospitalist and for the intensivists if it is late at night. That does score us some points. A friend recently intubated a laryngeal cancer patient with a cervical fusion and major hemoptysis who had failed bronchoscopy earlier in the day because the fiberoptic scope wouldn't pass his cancerous larynx. The intensivist actually came down to the ED later to give her a hug.

 

[docB]

Hi.

When I walk into a rotaton for the first time, I bellow, "I'm Panda Bear. The roughest, toughest, meanest, son-of-a-bitch you will ever meet and as I am an equal opportunity ass-kicker if I get one snide comment, one less-than-respectful remark, I will kick your mother-****ing ass."

Then I drop my pants, display my manhood and say, "If you can't top that, then shut the hell up!"

I'm actually not that big. Average really. Well, within two standard deviations whatever the case. Still, since nobody has the guts to drop their trousers they can protest all they want but I'm the only one flapping in the wind so I win by default.

Respect is earned, never given.

Glad I could help.

LOL!
I love it!
Since I'm not in residency I'm just going to do that every day when I walk into the ED. I'll let you know how it goes.

 

[BKN]

LOL!
I love it!
Since I'm not in residency I'm just going to do that every day when I walk into the ED. I'll let you know how it goes.

I"m not at all sure that Las Vegas is the right place to be droppin' trou in public. Some might think you're a professional doin' some advertising.

Or would anyone even notice?

 

[deleted87716]

You don't earn respect by what you do. You earn respect by how well you do it. And, by respecting everyone else.

 

[Taaki]

Hi.

When I walk into a rotaton for the first time, I bellow, "I'm Panda Bear. The roughest, toughest, meanest, son-of-a-bitch you will ever meet and as I am an equal opportunity ass-kicker if I get one snide comment, one less-than-respectful remark, I will kick your mother-****ing ass."

Then I drop my pants, display my manhood and say, "If you can't top that, then shut the hell up!"

I'm actually not that big. Average really. Well, within two standard deviations whatever the case. Still, since nobody has the guts to drop their trousers they can protest all they want but I'm the only one flapping in the wind so I win by default.

Respect is earned, never given.

Glad I could help.