Throwing the doc under the bus: Undermining trust and the doctor - WJBF-TV ABC 6 Augusta-Aiken

WNCN News

Throwing the doc under the bus: Undermining trust and the doctor-patient relationship

Posted: Updated:
Dr. Kevin Campbell Dr. Kevin Campbell
RALEIGH, N.C. -

We ALL try to do our very best for our patients.  Often the decisions we make have profound impacts on outcomes.  

Medicine is NOT always "cut and dry" and many times gut instinct and judgement calls must play a role in choosing therapies for patients (especially when made in the setting of best available data).  As it is in most professions, "Monday morning quarterbacking" frequently occurs in medicine as well.  It is much easier to make decisions and treatment choices when looking back on a case from the other side–it is much dustier in the trenches of an ongoing illness.

Today, in the New York Times, author Pauline Chen discusses the consequences that occur when doctors publicly (in front of other patients or colleagues) criticize another medical professional.  It is only human nature to want to present ourselves to our patients as the expert in a given area–the doctor with the best chance of making them better.  Unfortunately, some providers routinely make negative public comments about other physicians' abilities or treatment decisions.  Even though these comments may be accurate and well substantiated, these types of comments ultimately harm the patient and the healthcare system.  Certainly, many physicians see "protecting" patients from harm or substandard care as part of their job–rightly so–however, there are much better ways to accomplish this goal.

During training, even though much time is devoted to cultivating a culture of respect for and collaboration with colleagues from different specialties, incidences of "throwing {other doctors or teams} under the bus" can occur on a regular basis.  Fatigue and the pressures of training often play a role in the poor judgement associated with making derogatory comments.  In my experience in training these comments were often made between physicians of different specialties–such as internists vs. surgeons.  In training turf battles between specialties often deteriorated into negative commentary about the physicians or specialties in general.  These bad habits often translate into future lapses of judgement when in practice.  Instead of the sleep deprivation and military style training experienced by residents, pressures for increased productivity, increased documentation and higher volumes create the "mental fatigue" and frustration for the practicing physicians.  No physician is immune as we are all human–I myself have been guilty in the past of making negative comments about another physician who had a very high major complication rate in the Electrophysiology Lab.  Although my motivation for my comment was protecting patients from an incompetent surgeon, my course of action was flawed.  In the end, the physician was fired BUT, by making public comments concerning his abilities, I undermined the trust that patients have in their doctors.

It is essential that patients are able to trust their doctors to provide competent, compassionate care.  It is also essential that physicians stand up for their patients and speak up when they see care that it not up to standard.  However, physicians must utilize proper channels for addressing peer to peer related performance issues (such as medical staff QI committees, etc).  

Badmouthing colleagues reflects poorly on everyone involved and jeopardizes the doctor-patient relationship.  A recent study published in the Journal of General Internal Medicine explored the impact of doctors criticizing other doctors.  In the study the researchers found that critical comments were most often made about physicians in different specialties and resulted in higher levels of patient distrust in physicians in general.  It is very clear that we must do a better job of training physicians to work in a more collaborative way–constructive criticism (in the proper setting) can be beneficial to everyone.  However, publicly throwing a colleague "under the bus" is never the right answer.

  • Health with Dr. CampbellMore>>

  • Dr. Campbell: Backpack safety

    Dr. Campbell: Backpack safety

    Monday, August 25 2014 5:00 AM EDT2014-08-25 09:00:15 GMT
    As Students in our area go back to school, most will purchase a new backpack in order to carry essentials to and from school. It’s important to talk about keeping kids safe ---backpacks can result in back injury, but there are strategies to help you and your student pick the right type of backpack and use it properly, avoiding serious injury.
    As Students in our area go back to school, most will purchase a new backpack in order to carry essentials to and from school. It’s important to talk about keeping kids safe ---backpacks can result in back injury, but there are strategies to help you and your student pick the right type of backpack and use it properly, avoiding serious injury.
  • Dr. Campbell: The role of vaccines in school

    Dr. Campbell: The role of vaccines in school

    Friday, August 22 2014 9:28 AM EDT2014-08-22 13:28:00 GMT
    Infectious diseases account for millions of school days lost each year for kindergarten through 12th-grade public school students in the United States. Forty percent of children aged five to 17 years missed three or more school days in the past year because of illness or injury.
    Infectious diseases account for millions of school days lost each year for kindergarten through 12th-grade public school students in the United States. Forty percent of children aged five to 17 years missed three or more school days in the past year because of illness or injury.
  • Dr. Campbell: Robin Williams' death sheds light on depression

    Dr. Campbell: Robin Williams' death sheds light on depression

    Friday, August 15 2014 10:33 AM EDT2014-08-15 14:33:03 GMT
    Depression and bi-polar disorder are common ailments in the United States, Dr. Kevin Campbell said Thursday, after the death of star Robin Williams.
    Depression and bi-polar disorder are common ailments in the United States, Dr. Kevin Campbell said Thursday, after the death of star Robin Williams.
  • Trending StoriesTrending StoriesMore>>

  • 'Party mansion' in North Raleigh sells for $1 million

    'Party mansion' in North Raleigh sells for $1 million

    Tuesday, August 26 2014 12:42 PM EDT2014-08-26 16:42:52 GMT
    File photoFile photo
    A North Raleigh house commonly referred to as “the party mansion” sold last month for $1 million.
    A North Raleigh house commonly referred to as “the party mansion” sold last month for $1 million.
  • How to report drivers who pass stopped NC school buses

    How to report drivers who pass stopped NC school buses

    Monday, August 25 2014 5:25 PM EDT2014-08-25 21:25:40 GMT
    Thousands of motorists pass stopped school buses every day, and you can do something about it.The North Carolina Highway Patrol has a form for people who see a motorist pass a stopped school bus.Highway Patrol form to report drivers who pass school busesUnder North Carolina law, G.S. 20-217, drivers going either direction must stop when a school bus is stopped to let children off. Drivers are not supposed to continue until the bus has completed dropping the children off and begun to move agai...
    Thousands of motorists pass stopped school buses every day, and you can do something about it.The North Carolina Highway Patrol has a form for people who see a motorist pass a stopped school bus.Highway Patrol form to report drivers who pass school busesUnder North Carolina law, G.S. 20-217, drivers going either direction must stop when a school bus is stopped to let children off. Drivers are not supposed to continue until the bus has completed dropping the children off and begun to move agai...
  • NC has stiff penalties for passing stopped school bus

    NC has stiff penalties for passing stopped school bus

    Friday, August 22 2014 10:36 AM EDT2014-08-22 14:36:56 GMT
    Thousands of motorists pass stopped school buses every day, and many of them may not even realize they are breaking the law. It's an issue that has received intense attention in North Carolina, with 13 children being hit, and killed, at bus stops since 1999. One survey on March 26 of this year recorded 429 times where a driver roared past a stopped school bus in Wake County alone. In Durham County, there were 89 violations that same day and Cumberland County had a whopping 210. Johnston Coun...
    Thousands of motorists pass stopped school buses every day, and many of them may not even realize they are breaking the law. It's an issue that has received intense attention in North Carolina, with 13 children being hit, and killed, at bus stops since 1999. One survey on March 26 of this year recorded 429 times where a driver roared past a stopped school bus in Wake County alone. In Durham County, there were 89 violations that same day and Cumberland County had a whopping 210. Johnston Coun...
Powered by WorldNow

1336 Augusta West Parkway
Augusta, GA 30909

Telephone: 706.722.6664
Email: talkback6@wjbf.com

Can't find something?
Powered by WorldNow
All content © Copyright 2000 - 2014 Media General Communications Holdings, LLC. A Media General Company.