Collegiality

When David Halleran, MD, was elected president of the Community General Hospital medical staff last month, he carried a dictionary with him to the podium. He opened to the definition of “collegiality” and reminded his colleagues how important it is to maintain respect for one another and to work toward common purposes.

Dr. Halleran, who is a colon rectal surgeon, said that "collegiality" is the theme of his term of office, and he encouraged his colleagues to recall why they chose careers in medicine. He reminded them how satisfying it can be to collaborate with others on patient care. “It’s still a great profession,” he said, “when you are caring for the patient.”

The stresses and strains affecting doctors were recently the subject of a New York Times article, called “The Falling-Down Professions,” which said, among other things:

▪ About 60 percent of doctors reportedly have considered leaving the medical profession.
▪ Nearly 70 percent of doctors know a physician who has already left medicine.
▪ Applications to medical schools are down about nine percent from 1997.
▪ Physician incomes have lagged behind those of other professions.

As the Times reported, “Complaints about managed care crimping doctors’ income and authority over medical decisions are nothing new, but the problems are only getting worse…” It quoted a doctor's complaint: “What irritates me the most is the use of the term ‘provider.’ We (physicians) didn’t go to provider school.”

If physicians have become “providers,” patients have also become “consumers.” The imagery may be inexact, but the commercialization of the medical care process is clearly a factor in the changing doctor-doctor relationships, the changing doctor-patient relationships, and (as I can attest) the changing doctor-hospital relationships.

This week I again heard Dr. Halleran speak about collegiality, this time at a meeting of the Quality Committee of the Board. He said that collegiality involves more than “being cordial.” Collegiality facilitates more effective communications among physicians regarding patients and their care. It’s also facilitates physicians and nurses working effectively to improve patient safety and to assure that patients get the right care at the right time.

Professional collegiality, or the stresses and strains to which it is subject, is an issue bigger than our corner of the world. But I’m very happy to have Dr. Halleran calling us to order – and getting us to work on it.