Physician Team Cohesiveness

Recently, I attended our medical staff semi-annual meeting.  Two speakers (Dr. Usha Sathian and Dr. Lucky Jain) provided some impressive information about the growth of the hospital system’s outreach with ambulatory care services and about the development of Emory/associated institutions’ academic medicine advances.  The latter includes graduate medical education, extensive grants, and involvement in more than 1000 current clinical studies.  The number of trainees at all levels has grown incredibly.  These trainees are much more likely to stay in Georgia than trainees in many other parts of the country.

This growth corresponds to increases in the hospital’s bed capacity and technical abilities.  A third speaker, Dr. Joseph Rosenfeld, was honored for being both a community physician and attending physician for 40 years!  When he first arrived, there were eight pediatric ICU beds at Egleston Children’s hospital.  Now, there has been about an 8-fold increase.  The number of hospital beds has more than tripled.

Yet, sadly in my view, only a tiny number of physicians attended this meeting, a fraction that attended when the medical staff was much smaller.  Despite the huge increase in staff physicians, there is a dwindling number who attend meetings; this is true for grand rounds as well.  When I first arrived in town about 20 years ago, I looked forward to these meetings to engage and meet my colleagues.  In addition, due to ever larger number of subspecialists, it is much less frequent that when I rotate on hospital service that I will see the well-known neurologist, pulmonologist, endocrinologist, infectious disease expert and so many others.

I came away from the staff meeting with a tangible feeling that despite the incredible success of the system in developing improved capabilities that the feeling of working together as a team of subspecialists and generalists has diminished.  This makes me wonder whether other aspects of modern medicine and the worry over physician burnout are not related to increased isolation of physicians into their specialty silos and to cloistering into our computers and smartphones.

Though I feel grateful to be able to help children in my work, the biggest reason that I chose pediatrics was because of my admiration for the pediatricians I had met and my desire to both emulate their work and to work with them.  I think working closely together is one aspect that makes being a pediatric specialist worthwhile.

My take: Experts have recommended “peer support” to prevent burnout and increase job satisfaction.  My experience, which I suspect is shared widely, indicates that engaging with our peers is becoming less frequent.

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5 thoughts on “Physician Team Cohesiveness

  1. Oh, oh, oh……unfortunately this sounds so naive. Hospital systems see no value in these meetings. Emory as well as many other academic centers (and not so academic centers) are now MBA/corporate missions, the academic/collegial concept that leads to better medicine is not even an after thought. In fact, the corporate system may very well purposefully looking to eliminate interaction between physicians. Locally, I’ve seen grand rounds go online and now completely cut back. Physicians need to work more hours and see more patients and earn less. The trainees that have expanded at Emory, ha!…..they are being taught to approach medicine as a 9-5, punch-in/punch-out system. I was bothered by the previous posts on physician burnout, very little was discussed about lightening the workload and better compensation. I’m ready to work hard, but make sure the reward exists at the end.

    • I think the post is more nostalgic than naïve. The points you make are quite valid. In fact, I discussed with colleagues that the hospital system is not likely terribly concerned regarding physician involvement.

  2. Jay, I think you are really onto something here. We have lost in academic medicine one of the most glorious aspects of work in medicine — interaction with professional friends, colleagues and collaborators. The forces behind these trends are many, some which are mentioned by Ben above. This has been exacerbated by discussions of work-life balance, which cause many to dichotomize work and life. To me, this is wrong and adverse to joy in work. We should endorse work-life integration, which to me means participating more frequently in grand rounds, hospital functions, fundraisers and inviting colleagues for dinner, work parties and celebrations. Culturally we should do all we can as leaders to make our large workplaces feel small and more intimate. Others are thinking about these issues and I am optimistic, not pessimistic, that we can solve these quality of work issues. I commend to your reading the IHI Framework for Improving Joy in Work. The link is below. Hope you and your family and co-workers are doing well!

    http://www.ihi.org/resources/Pages/IHIWhitePapers/Framework-Improving-Joy-in-Work.aspx

  3. Pingback: Why Physician Burnout Is Happening & How to Fix It | gutsandgrowth

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