I can’t believe I’m writing something with this title. Anyone who knows me and sees my name next to that title will probably spit their coffee all over the kitchen counter. And to all the people who have dealt with me on call, let me begin by saying, I’m truly sorry for anything I might have said, done, thrown or broken. Mostly. Kinda mostly.
Those who know me will likely think that I’m either writing a bit of satire (“taking the piss” is the phrase that comes to mind), or it’s part of some court-ordered program. It’s neither. In reality, it’s an area that I work on as much as medical knowledge. Behavior counts for as much as knowledge in the practice of medicine. It’s a strange hybrid of intimacy and performance art. I’m regarded as being good at it.
I’m also a guy that does best when given a task and then left alone to complete it. Don’t interrupt, don’t change the assignment; just leave me alone and let me do my thing to a ridiculous level of perfectionism. The problem is that medicine is nothing like that. Medicine is a loose structure repeatedly pierced and upended by all manner of randomness throughout the day.
I regard my call experience as randomness taken to another level. And I said “my experience” because what I experience is very different from the reality of it all. The reality is that I work with cool people, and most calls I get are completely appropriate. Even the inappropriate ones generally have some interesting twist to them. But my experience is different. Emotionally, when I’m not at work, I’m not at work. My brain creates a black-white division that allows no intermingling. I’m the ultimate single task guy. Don’t interrupt. Can’t stand it; sudden changes are hard. And sudden changes that could come at any time, any hour of the day or night, are the worst. It’s not the call; it’s the vulnerability to interruption. It makes me really anxious. I do a lot of mental prep work to not be a jerk on call. Old dogs can learn new tricks and here are a few of mine:
1. Don’t deal with calls from patients, docs, nurses, etc. Deal with calls from people. Always begin the conversation by calling the person by their name. That helps remove any judgments, preconceptions or ill feelings. Person to person.
2. People are calling you because they need your help. It may not seem like much to me, but they have something that either worries them, or they need you to help with. Don’t judge it. Help with it. A bad attitude generally uses more time, drains more energy, leaves more ill will and produces a less satisfying outcome.
3. Every encounter is an advertisement. Seeing a patient is a privilege. For the most part, people choose physicians not just because of expertise but because they are nice. They’ve either met you or have a doc that knows you or have friends or family that have seen you. Behavior is a brand. I’m not being mercenary here and I’m not out hustling business. It’s simply true.
4. You’re part of a community. As a physician, particularly as a private practice physician in a smaller city, I constantly cross paths with patients, families of patients, and colleagues in lots of different settings. I’m part of a community. That means a lot to me. Maybe it’s a function of age or maybe it’s a function of no longer being part of the academic medical world. I’m not really sure. But as part of a community, I want to be viewed as a credit and a resource rather than a curmudgeon. We all really want the same things: to be liked and respected and appreciated. And if I want to be liked and respected and appreciated, I’ve got to first like and respect and appreciate others.
So, this is really normal social behavior 101, but we can all use a refresher, right? I know that’s very true for me. And I know that the better I am at doing with these things, the happier and more effortless my day is. I go to bed feeling like people walked away interactions with me feeling good.
I remain very much a student of the Zen of call. One of the great gifts of moving from academia into private practice was the realization that being successful in practice required being a good doc and being a good doc means being a good person in the community. It became an opportunity to re-evaluate and explore my life in a broader sense.
Change brings us opportunities to grow. And as a result of those changes, I feel that my life is broader and fuller and more balanced than ever before. And (most of the time), I’m nicer when you call me.
Michael P. Jones is a gastroenterologist.
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