Managing differences in opinions between attendings

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As a resident, I've come quite frequently into situations, particularly during signout, where the attending who's getting signout questions the decision making on the case and even though you might agree with them, you're held responsible for whatever the attending who saw the case decided. Most of the times the original attending is not even there, so you pretty much get the brunt of the criticism. What's the appropriate way of dealing with this stuff? Do you just take the criticism (sometimes bordering on abuse), or can you respectfully say that you agree with them? The latter does have the feeling though of throwing the attending who saw the case first under the bus.

Personally I think it's actually unprofessional to direct the brunt of the criticism at the resident and avoid saying anything to the attending. It's common knowledge that the most the resident can do is bring it up once or twice to the original attending, but it's really ultimately not the resident's decision. Recently I was in a similar situation, got a pretty nasty email (to the tone, "you knew this patient before. this is not x related") from the sign out attending. I just responded respectfully that I thought the same, as I thought it was important to set some kind of boundaries and not just let it slide.

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It sucks. And it's really hard to give any sort of generic advice. Each program has different dynamics and different expectations of how a resident works within the system and their responsibilities, and each attending has their own idea of these expectations as well.

That said, I'm concerned about anything you would classify as "bordering on abuse" regardless of circumstance. Personally I would seek advice from senior peers.
 
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This happened all the time when I was an intern. I told the truth and relayed that it was the previous attending's call
 
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yep. fresh intern. totally feeling that love. Or when an attending talks about such and such antidepressant is far superior to another. Then another attending will completely contradict that and ask why you're using that med..
 
Had an attending get passive-aggressive with me after I was called to the carpet to explain a decision and she didn't like it that I didn't throw myself on the sword as I was doing what I was told. This is the malignancy of medical education I dislike a lot.
 
At my program, a lot of the attendings have been there for a while. They pretty much know each other's styles, and we all know who most don't agree with. So at this point, it kinda goes as an unsaid thing when certain decisions were made, that the attending made you do it.

If questioned though, I just say what I truly think. Most of the time, that other attending knows I didn't necessarily agree/come up with their decision so it's not looked at as throwing them under the bus.

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