They.

They are the ones responsible for the waves of relief felt upon assurance during care. The ones who have dedicated immeasurable time and resource to learning as much about human medicine and science as possible. They have sacrificed personal moments and life milestones for medical service to others. They battle norms of traditional medical education with constant business change and regulatory demands. They balance hierarchy placed within their own groups as well as expectations to treat everyone within the organization as an equal. Their complaints about less and less face time with patients are heard but not resolved. They sit on committees, work groups, task forces and national strategic alliances…..and yet their personal health as professionals is almost never addressed.

They get up, go to work, have expectations of perfectionism placed upon them and absorb patient personal and social stress every day. They are the ones to deliver the bad news as often, if not more often, than the good news. Then they go home with the understanding they may be interrupted on behalf of a patient. They face unequal provider pay structures and challenged treatment plans.

They stick with it. They constantly look for better ways to treat in clinical care and some even go the route of physician scientist, always in search for a cure. They tell it to us straight: “enjoy life, it doesn’t last forever.”

They are physicians.

Yep, they make mistakes just like the rest of us. That’s okay because they are human. Like the rest of us.

Besides, it is a healthcare system’s responsibility to minimize human error through strong team work practice. Strong operations and team practice don’t take away moments of frustration or weakness, of course, but team work does allow for good catches. As a nurse at a downtown hospital, I once paged a resident twice requesting a reassessment of a patient I felt was in pulmonary/cardiac distress. It was the start of my shift but the resident had been rotating awhile. He was tired, busy and didn’t prioritize my concern. I advocated again, this time the patient was found to be in the middle of an MI and days later the same resident thanked me: both personally and through management accolade…..but he didn’t need to. That’s what teams are for.

When I’d forgotten to take the time to suggest a sleep aid for a patient two nights in a row? A gentle reminder from the physician provided all the difference. Again, teams.

They desperately want to make things better for patients and the public. Sometimes this means resistance to change for fear of the unknown and sometimes this means speaking up to bad change. Often this means work stress that compounds and carries out into frustrated communication. In multiple organizations I’ve received “advice” upon start as to which doctors were good coworkers. I never found this advice to be sound. In fact, I’ve gotten really good at smiling, nodding and then literally taking any “advice” on physician personality with a grain of salt. All too often I’ve seen allied health and nursing staff, like a gang, form the wrong approach against a doctor based on rumors and falsehoods. It’s best to reserve judgement…just like in personal life. After all, an open mind does wonders when starting any new relationship, including one with a physician.

On transplant and post-surgical floors I was warned of a couple personalities that were “tough”. I was even advised when I started that a couple surgeons may challenge my work in an unprofessional manner. Not only did this never occur (not once) but, as a new nurse, I was even given full attention and asked for decision weigh in. I also quickly found the patients loved these doctors not because of the life-saving procedures but because of the way the patients were valued.

They prioritize everyone else first.

Negotiating care for those who couldn’t pay within a county? It was physicians who grouped together in effort to see these patients, at private clinics and through volunteering, to provide equitable care. It was physicians who advocated alongside hospital leadership on behalf of the patients. It was physicians who provided countless suggestions on new ways to manage this population to me privately. It was them.

Oh, they need reminders too, because they are human.

They need gentle reminders that systems may not run as smooth as we first wish. Proactive communication goes a long way in this instance.

They may need reminders that others in healthcare decided not to become doctors and this decision doesn’t make others’ work any less equal.

They need reminders to take time away, to not be perfectionistic, to have fun, to not buy into “herd” mentality as it pertains to organizational gossip. They need reminders that not all business operations are bureaucratic.

They need reminders that “this is the way it has always been” doesn’t equate to “the way it should be” (which is especially true with titles, awards and hierarchies pertaining to seniority in medicine).

A mother of an adult patient called me into the room one evening. Out of the blue, the patient was seizing. I pivoted out to call for the resident who’d been at the nurse’s station. As I looked over, the resident jumped out of his chair and ran over to me. Later on, when everything was resolved I’d asked how he knew I needed help. He said he’d just gotten to know me well enough that I didn’t have to say anything. That’s the ideal way it should be for teams. And he is one of the best surgeons I know.

Another one of the best physicians I’ll ever work with was one that oversees the public’s health in a large county. Viewed as equals, public health professionals work alongside this physician. As the priority, the public’s interest is her true passion. Even when looking to problem solve in another role for county-wide health access, my concerns were validated and data searching supported. She is one of they, and they ought to be viewed from all these spotlights.

They need reminders that TLC for physicians must be built into the organization. It’s not a luxury, it is a necessity. Any respectable organization will provide this culture in the immediate future.

They need reminders that corporate lawyers in healthcare do not always have physicians’ best interests at heart. In fact, trust in medicine is essential. Honesty, truth and integrity for a physician or physician’s group is more important than the corporate lawyer panel. It is okay to challenge and speak up…especially for the physician. Trust and honesty is everything.

Physicians are often praised in ways where some, like any other profession, develop dangerous egos. All too often, this culture is cherished and continued. However the culture of physician understanding, deep relationship respect, organizational open communication and the culture that demands the removal of disheartening hierarchies is under-represented. The culture that demands positive TLC for the physician is non-existent. And, the culture that values physician and staff mutual admiration at times is intentionally removed.

Once I was assigned a patient who’d been hospitalized multiple times. This time she’d already been with us for a few days and I was new to her. I’d heard an arrhythmia, checked the chart and nothing was previously documented. Though some staff mentioned that the lead surgeon was notorious for his communication preferences and was also in “total control” of his patients, I didn’t listen. I knew better. He was always my colleague and my peer even if he didn’t know me that well personally. So this morning I sent him a general page on the arrhythmia anyway. Within the hour I walked in her room for another matter and the ECG tech was already there. He’d ordered it and noted it.

Like I said, he was my colleague. They are on our team. Despite what anyone else says.

And, despite any perception to the contrary, they respect everyone.

They take the time to teach and to learn. Never before had I found a true friend in my physician colleague until working in student health. After collaborating with these doctors, I understood physician workplace teaching at its finest.

They are one profession in a sea of healthcare. They must have support through positive culture that is shaped, developed and shared. They deserve it.

I walked in a room once during the middle of a shift on the transplant unit. The middle-aged patient was crying. He apologized and I assured there was no need. He told me that he and his family just finished praying as he was just so thankful for his doctor. I kept it private as he wished. This is a true story.

They are valued in ways they may not always realize.

In the ever-constant changing world of health, one thing is certain: they are part of us. They are on our team. To let any circumstance or anyone intentionally come in between would be a disservice to all. Instead of removing foundations, let’s actively build structure for physician workplace culture.

And sure, the saying stands: it’s not us and them, it’s we.

Once in a while though, a clear distinction is of tremendous value. So for the record:

They are physicians. And they are on our team.