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The importance of good professional relationships

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‘Turf wars make a mockery of medical professionalism, the dignity of the profession and collegiality. The real competition in medicine is against disease and ignorance, and the focus of doctors’ efforts is in reducing the suffering of patients from illness.’
 
These earnest sentiments from Associate Professor Thiru Thirumoorthy cast a necessary spotlight on the importance of maintaining respectful, humble, and harmonious relationships with colleagues.
 
More importantly though, such relationships are sought for a more critical purpose – achieving optimal patient outcomes, reporting near misses and reducing the incidence of adverse events.
 
A culture where patient safety is the focus is essential.
 
Recently, a study out of Queensland revealed that unacceptable behaviour between healthcare workers may increase the frequency of medical errors, adverse events and healthcare-related complications.
 
Despite the inevitable competition in medical practice, it should be subservient to the professional component of medical practice to benefit patients which, ironically, is what is likely to lead to the respect of (and maybe referrals from) colleagues.
 
Section 5.2 of Good medical practice: A code of conduct for doctors in Australia states that ‘good patient care is enhanced when there is mutual respect and clear communication between all healthcare professionals involved in the care of the patient’.
 
Good medical practice involves:

• acknowledging and respecting the contribution of all healthcare professionals involved in the care of the patient (section 5.2.1)
• communicating clearly, effectively, courteously, respectfully and promptly with other doctors and healthcare professionals caring for the patient (section 5.2.2)
• behaving professionally and courteously to colleagues and other practitioners, including when using social media (section 5.2.3).

A South Australian coronial inquiry in which two stroke patients died found that, in the 2017 incidents, a failure by one interventional neuroradiologist to arrange another to cover for her while she was on leave resulted from ‘personal antipathy that existed between them’.
 
Had interventional neuroradiology services been available at the hospital, the outcomes may have been different for the patients who required clot retrieval.
 
As was succinctly described in a 2019 Trust in Health Care article:
 
‘The goal in recognising and negotiating differences is not to be right, to win a contest, or to dominate others [goals that are based in ego and are ultimately unprofessional] but rather to learn, to discern the wisest course of action, and to align everyone involved in carrying out that course of action [goals based in service].’
 
Eleven ways to promote good professional relationships

1. Limit the contents of medical records to patient care (eg refrain from criticising colleagues in the records)
2. Acknowledge the contributions of others
3. Advocate for colleagues
4. Deal with any dispute with a colleague quickly, professionally and without involving patients
5. When raising concerns with a colleague over a disagreement about patient care, emphasise the importance of achieving the best outcome for the patient, while maintaining respect for your colleague, and attempt to negotiate a mutually agreeable resolution
6. When making suggestions for improvements, frame the conversation in terms of the risk to everyone concerned
7. Be aware of the potential for colleagues being in distress or impaired when communicating with them
8. Never air grievances on social media or by email
9. Use conferences as an opportunity to network and seek colleagues’ views on challenging clinical issues
10. Value differences in perspective and harness them as a resource
11. Acknowledge and politely address disrespectful behaviour of colleagues to create the highest quality work environment

It is imperative that the wellbeing of patients outweighs any personal conflict between doctors when determining what has been done and what is now to be done in relation to patient care.
 
If it does not, adverse events may arise leading to outcomes which will have greater repercussions than having a ‘win’ in a stoush with a colleague.
 
Concentrating your efforts on high-risk areas, with the best interest of patients at the core, will help facilitate the most beneficial outcome and, probably, the most personal satisfaction.
 
MDA National offers workshops on enhancing team dynamics and resolving conflict with colleagues. Information on upcoming sessions is available on the events webpage.
 
This article is provided by MDA National. They recommend that you contact your indemnity provider if you need specific advice in relation to your insurance policy or medico-legal matters. Members can contact MDA National for specific advice on freecall 1800 011 255 or use the ‘contact us’ form at mdanational.com.au
 
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MDA National medico-legal personal relationships

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