The Brindley sessions brings the brilliance of Peter Brindley to the EMCrit Podcast. Our first topic of conversation is rudeness and its ill effects on the medical team. Peter gave a great lecture on this topic at SmaccDUB, but I wanted to hear more.
Part II on Rudness is now up as well
Dr. Peter Brindley
Peter Brindley MD, FRCPC, FRCP (Lond), FRCP (Edin), Full-time Critical Care Doc from the University of Alberta Hospital. To the surprise of many (himself included) he is a Professor of Critical Care Medicine, Anaesthesiology, and Medical Ethics. He has authored 90 peer-reviewed manuscripts, 25 book chapters, 50 lesser manuscripts, and has two textbooks pending. He has given over 300 invited presentations in 10 countries, and over 30 plenaries. He was a founding member of the Canadian Resuscitation Institute; and was perviously Medical-Lead for Simulation, Residency Program Director, and Education Lead at the UofA. He has advised the Canadian Patient Safety Institute, and the Royal Colleges of Canada and of Edinburgh. There are many better speakers, but none happier to be here. He welcomes questions; comments and especially disagreements: after all he doesn’t wish to be wrong a moment longer than absolutely necessary.
Some Studies & Papers
- RCT of the effects of rudeness on team performance (CoreEM discussion of this paper)
- Improving Verbal Communication in Critical Care
- Improving Teamwork
- Questionnaire Study on Rudeness
- More Rudeness
- McLuhan on the Medium is the Message
Verbal AiKiDo aka Dealing with Assholes
Psychologist Albert Bernstein recommends these three tips:
- Say, “Please speak more slowly, I’d like to help” or some variation thereof. Doesn't matter if they are already speaking slow as molasses.
- Ask, “What would you like me to do to make this better.” or ANY other question. Questions short circuit the anger cycle.
- Let them have the last word
See more from this post
Rudeness Affects Team Performance as well
Pediatrics. 2017 Jan 10. pii: e20162305. doi: 10.1542/peds.2016-2305.
Rudeness and Medical Team Performance.
And Another…
Now on to the Session…
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Dear Dr Weingart. I am very happy that somebody speaks about those topics that are also a very important part of wellbeing. I am a prehospital em doc, family medicine and this year I enrolled in family and relational psychotherapy study. I find one thing very useful in defusing an angry consultant. Its apology. Not a guilty, i-make-myself-small, sorry to disturb you, like. But empathic apology which I make because of myself. It is hard to find that in a moment before reacting, but if you do results are surprising. An example would be: I am really sorry that my… Read more »
indeed, though those kind of apologies–i.e. “I’m sorry you are upset” can sometimes backfire. If you can be egoless enough to simply say, “I’m sorry” with nothing added on and then stay silent while they wait for you to add the but, but then don’t add the but.
Gentleman I really enjoyed this talk. I’ve presented on this subject and struggled with my response to rudeness. I historically have been a very visceral responder and have many examples of scenarios where in retrospect my counter aggression was misplaced. I think EM attendings are often treated as residents. This culture in part relates to our notably non-hierarchal system where staff are always present in the Department and our sterotypical relationships with residents is more collegial, friend-like. This may seem a positive thing but its not when assholes are involved. We have to disrupt the daily activities of others to… Read more »
thanks so much for adding your thoughts here, buddy
[…] Published 2016. Accessed December 14, 2016. 4. The Brindley Sessions: Rudeness. EMCRIT. https://emcrit.org/wee/brindley-sessions-rudeness/. Published 2016. Accessed December 14, 2016. 5. What do Donald Trump and Emergency Medicine […]
Thanks again Scott from bringing up this very interesting topic. I am a French ER physician with a 12+ years experience and we too are often facing this type of behaviors. Two years ago in my department, we reached a point where some of our trainees were scared of calling some specialists (mostly surgeons) for fear of being in a bullied. It was mostly towards ER trainees or young ER physicians. And that is where we thought it started to become dangerous for our patients, when doctors where avoiding doing the right thing for fear of being bullied. Some of… Read more »
this whole comment is gold, but the “an inappropriate behavior filter” on the phone just made my day. : )
Thanks so much for these podcasts on rudeness. I’m still in my first few years of ED training (having practised in other areas prior) and find this a very difficult topic. I’ve experienced rudeness much more frequently in ED than any other area I’ve worked in and I think this is for 2 reasons; firstly because some, not all, but some, hospitalists think that we’re not ‘the specialists’ and our medical opinions are not worth anything. And second, because the specialist teams perceive us as creating more work for them when they’re already stressed and busy. Being made to feel… Read more »
amazing stuff, thanks so much for taking the time to post this, Anna
Always great to hear my old colleague Pete speak. Question for the two of you “is being rude ever appropriate”. And what constitutes rudeness? As both an EM and Intensive care physician I see lots of Disposition-EM being practiced. Humbly I propose that a consultant should be utilized to further the patients needs; after exhaustion of the skills within the scope of ones specialties, Using consultants to lessen ones workload or disposition angst – I would suggest is rude – albeit in a passive aggressive manner. This is becoming the culture – the drivers of which are many. Always happy… Read more »
Stu-your complaints are well founded, I have witnessed this bad behavior many times myself while working both jobs (ED and ICU). This however is not rudeness, it is simply inappropriate doctoring. If they also act like an asshole when they are trying to dump on you–that is rudeness. If they are polite while dumping, it is not. Rudeness is NEVER appropriate.
[…] Published 2016. Accessed December 14, 2016.4.The Brindley Sessions: Rudeness. EMCRIT. https://emcrit.org/wee/brindley-sessions-rudeness/. Published 2016. Accessed December 14, 2016.5.What do Donald Trump and Emergency Medicine have in […]