Bedside Manners: CFJT: Curb Your Docs! By Patricia L. Raymond, MD, FACP, FACG
Photo by Christian Schart
CFJT? What, you may ask, is a CFJT?
Dear readers, I am happy to reply.
CFJT is from a story from recent news. A rash of carjacking was occurring at a California airport, the lone carjacker stealing rental cars for a joy ride near the arrivals terminal. The newly arrived, distracted by long hours of travel and luggage loading, simply failed to notice the lone carjacker slipping behind the wheel and speeding away with their ride, as well as any luggage that they had already loaded into the trunk.
This sunny California day, the carjacker struck, nabbing a late model sedan. Before he had left the terminal area, he spied a better target. A rental van, surrounded by ladies with distinctive hair in hues of grey, all garbed in matching pink sweatsuits. Mounds of luggage were being packed in the trunk space. A easy haul.
The carjacker failed to comprehend the meaning of the lettering on the pink sweats: CFJT.
As the ladies later kindly explained to him, the letters stood for “Central Florida Judo Team”, in town for an exhibition. Of course, they kindly explained this to him as held his face to the floormat as they awaited the arrival of the authorities.
What does this all have to do with your cranky docs? It’s simple. I plan to make you the Central Florida Judo Team of good behavior in your hospital. Together we’ll practice the holds, the throws, the locks needed to wrestle good bedside manners from your colleagues.
It will take practice. Consider me your sensei.
But it’s more than just having the diligence to take on the rude behavior. We need to assume that you won’t continuously have to work to change the behavior. We must assume that doctors are trainable.
Trainable? Doctors around you can be trained to exhibit good behavior to the staff?
Absolutely. Doctors, despite having large and multifaceted brains, are infinitely suggestible. Until this January, drug companies expended bunches-o-bucks annually to keep us in notepads and pens. You think that they did that so that I could jot down my shopping list so as to not forget to pick up a pound of zucchini at Piggly-Wiggly?
In fact, the recent Pharma laws prohibiting writing instruments and notepads stem from research that shows that doctors are immensely suggestible and trainable. While it’s not today’s topic, you can read more at http://NoFreeLunch.org
So how do we take advantage of the trainability of your docs? Just think of them as a new puppy, recently liberated from pet adoption day at your local Pet Smart. You bring the puppy home, only realizing as you enter your home that you have recently redecorated; classy white rugs and furniture. You leave the puppy alone in your living room, just for a moment. He can’t get into any trouble in a moment, you assure yourself.
You fool.
You return to your living room, and find the puppy, and the spreading yellow stain in the middle of your carpet.
You’ve got choices at this juncture, just as you do at your hospital. You can notify your supervisor, who will send a report to the puppy’s department chair, who will deliberate and finally send a sternly worded note to the puppy which will arrive about three weeks after the incident. The puppy will be baffled by the note, not remembering the incident at all.
Or, you can whack the puppy with a rolled up newspaper.
Don’t get me wrong. I am pleased that most hospitals now take physician misbehavior seriously. However, if the response to misbehavior is not immediate, the puppy will not learn. As the recipient of such a letter in the past, I can assure you that the response is “Wha…?”, rather than any large “I’ll treat my staff better in the future” light bulb illuminating.
But here’s the deal, carrying the puppy analogy further. You must be immediate, persistent, consistent, and insistent.
BE IMMEDIATE: Peeing on your rug must have immediate consequences. Whacking the puppy weeks after an incident will not cause change.
BE PERSISTENT: Whacking the puppy only one time will not change his behavior. Puppies take time to train. Most puppies are trainable; only a few are returned to the shelter.
BE CONSISTENT: Whacking the puppy only occasionally after peeing will only confuse the puppy.
BE INSISTENT: You deserve a pee-free environment. If all in your unit-household do not concur on proper puppy behavior, if only some train the puppy and not others, the puppy won’t get trained. Insist that you deserve a collegial working environment.
I’ll provide the training tools for behavioral change. It’s time to learn to curb your docs.
In the coming months, we’ll explore how to best train your medical puppy as well as how social changes have caused discord in the traditional healthcare family. Meanwhile, share your fun, weird, and scary physician interaction stories with me, via JNJ. With your permission, we’ll discuss the scenario, grin at the physician craziness, and try to figure out where we could have influenced the outcome to a win for both sides. Meanwhile, you can catch up with prior articles in this series:
“I Spy With My Little Eye”, JNJ January 2009 here and “Chronic Cranky Caregiver”, JNJ February 2009 here
©2009 Patricia Raymond
Tags: CFJT, doctors, Dr. Patricia Raymond, Judo, persistance, puppies, Zucchini