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A common educational experience brings us together, builds collegiality
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While flying back to the mainland from Orthopedics Today Hawaii, I reminisced about the many memorable interactions I had had with some of the more than 450 attendees and faculty members. The undisturbed time on the plane enabled me to formulate my thoughts as to why this particular educational experience is so enjoyable for me to participate in each year.
Other outstanding educational experiences are available to orthopedic surgeons, but to me, this course offers a special flavor. Orthopedics Today Hawaii is an opportunity for education in a beautiful setting, where the attendees and faculty are relaxed. Each year the carefully chosen faculty of outstanding educators who are heavily involved in clinical orthopedics excel in the interactive educational curriculum. The faculty members enjoy answering difficult questions and often bring humor to their presentations, interactions and responses.
For me, the special camaraderie among colleagues and faculty improves every year. My reflections took me back to my residency where collegiality was strong as we worked toward a common purpose, and respected and listened to each other. That is what made me realize that collegiality is what makes this particular educational experience so enjoyable for me.
Basis for collegiality
Respect is the foundation of collegiality. We all experience collegiality when we trust and share information with other physicians during patient care. I am from the “old school” and hope the “ongoing school” also believes that interactions with medical colleagues deserve a type of codified professionalism. Many medical organizations have developed a “code of medical collegiality” — that serves as guidelines for behavior based on collegial principles in mutual relationships among physicians. It is important to note, however, that none of the codes in the various medical organizations protect physicians from the consequences of misconduct, malpractice or fraudulent behavior.
Douglas W.
Jackson
As professionals, we should be above labeling and demonizing each other in the media. I feel that we should not show antagonism, hostility or unfriendly behavior in dealings with our colleagues. Besides caring for patients, for me, there is no better place than a common educational experience to bring us together and make us appreciate collegiality. The challenge is to carry that spirit back to our communities and organizations, as well as set an example for young physicians. Our students will see these respectful interchanges among physicians, and hopefully, will emulate it in their relationships with their colleagues when they start practicing medicine.
Changing trends
In addition to the core curriculum, this year’s Orthopedics Today Hawaii gave me the opportunity to talk about the real transitions occurring in medicine. I enjoyed hearing the insights and experiences of colleagues from around the United States, particularly the trend of physicians to become employees rather than self-employed. My colleagues described their feelings and the pressures to survive, so they sought employment with health systems or large physician groups.
Physician employment is generational to some degree. Physicians in training appear to be more willing to sacrifice some income for a better quality of life and are less interested in the risks and entrepreneurship required to run a private practice. In addition, regular hours and reduced responsibility for patients after hours are more of a priority. The net effect appears to be that in 2013, at least half of physicians already are employed by health systems or large groups and more physicians will be moving in that direction.
The employment discussions included the specific contracting issues that attendees and faculty face around the United States. The discussions expanded to concerns about new measures for controlling costs, and we had a leading health care attorney and administrative expert give their perspectives. The migration of physicians into large, regulated entities is essential to the way current health policy planners feel health care costs can be controlled.
Attendees expressed concerns about how orthopedic surgeons, as a profession, need to maintain the necessary autonomy and independent clinical judgment to maintain a high level of patient care and quality. Beside the pressure from controlling reimbursement and prices, there is the rapid trend toward standardization. We need to remain responsible for therapeutic interventions and work together to “care and cure the sick.” We have a moral commitment to the patient and hopefully we will adhere to our professional code of collegiality during these changing and challenging times.
Focus on commitment
As physicians, we are well-educated and expensive to train. Our decisions have substantial significance in the lives of others. New health care laws have the potential to turn physicians into service workers. We have already seen many of the same pressures exerted on teachers, police forces, firefighters and other health care providers. They came to their careers with a passion and commitment; yet, now depend heavily on union structures to obtain influence.
Whatever system and changes finally evolve for physicians, our commitment to patients and quality care has to remain our main focus. Likewise, our commitment to collegial interactions with each other in the process will also be beneficial to medical care and patients.
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