There are Different Expectations for Physicians

A colleague recently asked me my opinion about how to handle family emergencies (sick kid, snow day, daycare crisis) with a physician colleague vs. a staff member. I had to think hard about this. The members of our care teams - nurses, medical assistants, receptionists, and providers -are equal in deserving respect. So, on face value, I would say that physicians and staff should be treated the same - same expectations, same rules, same treatment.

But then I thought about it more…

Physicians are no more important than anyone else who serves our patients, but they are also no less important. There are many aspects of patient care that are fully in the purview of a physician and many more that could be done by someone else but end up on the physician's plate because ultimately the physician is responsible. Additionally, physicians take call, round early, work beyond the end of a workday, attend meetings, and ultimately drive the entire business of a healthcare organization. Again - not any more important but no less important. The point is that physicians are often expected to go above and beyond, and this is okay. We knew what we were signing up for and the respect afforded us along with our compensation reflects our unique role.

When a crisis strikes a physician, I would offer that it is appropriate that the member of the team who must see the patients, deliver the baby, take call, call in an order at 3 a.m. be afforded more latitude in managing their personal life so that they can give what is needed professionally.

This could mean taking a child to work on a snow day, rearranging a schedule last minute to accommodate an urgent family need while trying to minimize patient inconvenience, or providing personal support to help a physician group when they need to take extra call. Stanford piloted a program allowing physicians to "time-bank" in exchange for picking up extra shifts and other time consuming activities. Part of the impetus for this program was the alarming rate of burnout and the high number of hours physicians work in comparison to other professions.

Physicians expect to work hard and make sacrifices. They are also highly dedicated to patient well-being, which often leads to the hard work and sacrifices. This will probably always be true of medicine to an extent. However, there is an urgent need to support physicians in other ways so that they have the emotional bandwidth and energy to do those things that physicians have always done without requiring them to sacrifice unnecessarily.

So my advice to my colleague was this. Explain to the staff that the expectations for physicians and other staff is different, which is why physicians are expected to respond at 3 am and a clinic nurse is not. Appreciate everyone's contributions. Recognize that physicians often will sacrifice themselves and their families for the wellbeing of their patients, so meet any needs you can so that the sacrifices are minimized.