So Happy Together

February 7, 2008
Robert Lamberts, MD

I know this may come as a terrible shock to some of my readers, but humility and cooperation are not skills embraced by every physician.

I know this may come as a terrible shock to some of my readers, but humility and cooperation are not skills embraced by every physician. To be sure, in a room filled with fifty physicians and a single door, you will get fifty plans on how to leave. We are trained to trust our own judgment. So is it possible for a group of physicians to work together without playing a continual game of “King of the Hill”?

Yes. We have achieved this in our practice, which is a philosophic mishmash. Two of our physicians are board-certified in internal medicine and pediatrics; the other three, family medicine. These two methods of primary-care training differ vastly, yet, to date, we have successfully avoided armed conflict and even fistfights. This is even more remarkable if you consider that nearly 15 years separates the training of the most “seasoned” physician (ahem, me) and the newest physician. And I’m proud to say we five doctors go beyond simply coexisting; rather, we thrive on our training differences and pretty much agree to practice medicine in a similar manner.

Here are some key ways to promote solidarity:

  • Hire like-minded doctors. Try to bring people into your practice who have similar professional and lifestyle goals. If one physician pines for a Rolls Royce, while you aspire to part-time missionary work, you may find it hard to agree on managerial and financial goals for the practice. Priorities need to be in sync.

  • Centralize phones. For those offices using electronic medical records, make sure all nurses take responsibility for all phone calls, regardless of their physician assignments. This makes it less likely that doctors or nurses will establish habits that are significantly different from others in the office.

  • Develop protocols. Set up management protocols for nurses and doctors for various disease processes. New nurses should be trained using these protocols. Again, for offices using an EMR, you can (probably) set up reminders that will prompt physicians to follow agreed-upon protocols.

  • Talk. Hold regular discussion of cases and review mistakes made by everybody. Constructive criticism seems less like finger-pointing when the lead physician is held as accountable as the newest nurse. When news comes out about a drug recall or a controversial study, discuss among your physicians how to respond when patients ask questions, and then disseminate the practice’s official stance to your staff.

  • Part ways, if necessary. Encourage your physicians to be upfront if things are not working out. This is incredibly hard to do and it may even set the practice back financially for a while, but when practice styles are too different or personalities clash, maintaining control of the practice direction trumps maintaining cash flow.

By taking steps such as these, you’ll grow from each other’s knowledge. You’ll also find your patients are more satisfied with the care they are getting from any physician in the practice -- surely a worthwhile goal.

Robert Lamberts, MD, is a primary care physician with Evans Medical Group, in Evans, Georgia. He is board certified in internal medicine and pediatrics and specializes in the care of adults, pediatrics, diabetes, high blood pressure, asthma, preventative medicine, attention deficit disorder and emotional/behavior disorders. Dr. Lamberts serves on multiple committees at several national organizations for the promotion of computerized health records, for which he is a recognized national speaker. He can be reached at rob.lamberts@gmail.com.