REFLECT

Model stories written by young professionals/students.

 

The "I" in Medicine

 

 

As every child knows, there is no “I” in team. As we mature, the values of cooperation and teamwork are engrained within us. These values have lasting relevance in medicine; in fact, cooperation and teamwork are some of the central values of modern medicine. The healthcare community has synthesized these values into the “I” of medicine: interprofessionalism. Interprofessionalism is valued in nearly every facet of healthcare, whether it be the operating room or the waiting room. How doctors interact with nurses, administration, physician assistants, and other health personnel is integral to the diagnosis and treatment of disease. Maintaining a professional relationship is difficult but important for the environment of the hospital.

Interprofessional relationships contribute to the perception of the hospital environment. As described by Adam Reich in Selling Our Souls, a hospital in which the nurses, physicians, and other hospital personnel are competitive and not cooperative make for poorer practice and a very negative work environment. Despite the success of the hospital, people want to work in a positive environment, and are even willing to sacrifice a little quality for it (Reich). In the medicine, there is a hierarchy. The key to interprofessionalism is to grey the lines between the levels. After all, the entire team is required to properly care for patients. In Boys in White, Howard Becker described the resentment between levels of the hierarchy due to differing level of responsibility over a patient’s care. In modern medicine, interprofessional diagnosis and treatment is the direction of the future. The medical field recognizes the important perspective that a team may offer to care. And, a healthcare team with strong interprofessional relationships can optimize treatment and perception of the environment.

I have witnessed various level of interprofessionalism on my many shadowing experiences. I have witnessed team-based medicine that was positive and very successful. I have also been on an experience in which there appeared to be a lot of physician resentment and a lack of teamwork. During an ER shadowing experience, I shadowed the attending physician, but also the very large team of surgical residents and nurses. I was amazed at the supporting environment and the skills they used to work together. The emergency unit is a very fast paced, stressful environment. Interprofessionalism is important to treat the variety of patients coming into the ER. Every member of the team understood his or her role. Conversely, while shadowing an orthopedic surgeon I witnessed a negative hospital environment. The physician and team were incredibly talented and committed to their work, but there was very little communication between the members of the team. At one point the physician attempted to use a scope that was cloudy. He quickly demanded a new one because it was “unacceptable.” The surgical team shrugged in annoyance. To me, they were not connected and had issues with the responsibility hierarchy described by (Becker et. al).  

Interprofessionalism is crucial for medical success, but it is not natural. It is a skill that must be learned. Working with others from diverse backgrounds requires flexibility and understanding. Developing interprofessional skills requires practice and exposure to team-based learning. On a previous shadowing experience, I asked the attending physician if he had been trained to work with nurses and physician assistants. He expressed that it wasn’t “necessary” for him because they are trained to work with him. I believe it is essential to train physicians to work with other members of the healthcare team because physicians are unable to treat patients single-handedly. Every member of the healthcare team has an essential role in care for the patient. Modern medicine is moving towards a team-based approach to medical practice; I think this should be mimicked in medical education. A possible way to facilitate interprofessionalism is to teach medical students with nurses and physician assistants during their clinical exposure time. Understanding each member of the group’s role is crucially important for developing a strong interprofessional relationship. We can’t expect our physicians to have this skill, they must be taught it early.

The days of single doctor-patient relationships are long gone. Modern medicine values interprofessional relationships between physicians and other medical personnel. Teamwork promotes a positive hospital environment and provides the patient with maximum support. Though medicine values interprofessionalism, it, perhaps, is not being taught to future doctors. They are expected to learn the skill with experience. I believe medical schools should emphasize interprofessionalism and train medical students for team-based diagnoses.  

-AE VonAxelson

Works Cited

Becker, Howard S., Blanche Geer, Everett Hughes, and Anslem Strauss. "The Assimilation of Medical Values by Students." Boys in White; Student Culture in Medical School. By Howard S. Becker. Chicago: U of Chicago, 1961. 239-73. Print.

Reich, Adam D. "Introduction." Selling Our Souls: The Commodification of Hospital Care in the United States. Princeton: Princeton UP, 2014. Np. Print.