Have you ever had a consultant act in a way that was rude or dismissive? A bit of a jerk? Does that question seem rhetorical?
Confession:
I’ve been that jerk on the other end of the line, while simultaneously lamenting whenever it happened to me.
Such a hypocrite.
The End-of-Day ‘Dump’
Emergency medicine has no gatekeeper. Any doctor can send a patient at any time.
At 10 am, I was as pleasant as hot apple pie and ice cream.
At 4:55 pm (or pick whatever time a clinic shutters), it was a different story. I wasn’t hostile, but my tone said, “Really? You’re dumping this on me now?”
Overheard by the Boss
My ED director, a wizened doc with 40 years experience, heard one of these calls and said:
“Why waste the energy? That patient’s coming no matter what. Just say yes. Once you know you’re saying yes, ask yourself: How can I be as helpful as possible?”
He was right. I’d been burning energy acting annoyed. Just saying, “Yes, send them on in,” freed me up mentally and emotionally. It probably made life better for the doc on the other end, too.
Sometimes It’s Us
In our Unburnable course, there’s an entire module on Navigating the Difficult Consultant. It’s one of the most popular sessions because nearly every clinician has been on the receiving end of a condescending colleague.
What’s harder to admit is that sometimes we’re the difficult consultant.
A New Default
Once I committed to “yes,” everything got easier.
I felt helpful instead of dumped on. Unwittingly, I’d been setting myself up as a victim.
Were all of those patient transfers “appropriate” for the ED? Probably not, if you define appropriate as only true emergencies. But appropriate is a loaded term.
Sometimes it just means the clinic is closing, and there is no one else to care for the patient.
The Tables Turned
Later, I worked in those same clinics. At closing time, I was the one transferring patients.
When I got attitude from a particular ED doc, universally known as a phone call hassler, I recognized the voice.
It used to be mine.
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