Teamwork is a Problem in Healthcare: So, What next?

I have tried to resist the temptation to write on teamwork for some time now. I realize that I may ruffle a few feathers with this post so I am already bracing up for any possible backlash.

It is common knowledge that there is a lot of in-fighting among healthcare professionals. This problem is endemic worldwide; physicians vs. nurses, laboratory scientists vs. physicians, pharmacists vs. physicians, and the strife is endless. One recurring decimal seems to be that other healthcare professionals are at peace with themselves but have issues to grind with physicians. I don’t have a high-tech solution for this problem. I think it probably just comes down to simple things like interpersonal skills, prejudices and stereotyping.

Let us consider some of the factors associated with this problem.

Ego and Arrogance

A classmate of mine had his mum on the staff of the Teaching Hospital while we were still students. She was a matron in one of the units. All her colleagues were nice and treated us like their own children. Imagine the gross reversal of roles when the ‘children’ qualified as physicians and the nurses had to take ‘instructions’ from them!

Medical professionals typically have large egos. For example:

Many physicians feel they possess all the knowledge in the world. Maybe, they feel that way because they are always ‘inside’ the human body. This feeling may also be reinforced by patients. Sometime back, after seeing a patient wheeled out of the operating theater, someone remarked that ‘doctors are next to God in knowledge and ability’. Really???

Many nurses on their own part feel that they are indispensable. They seem to have an exaggerated opinion of their abilities. This ego is reflective on their relationships with other team members.

Some pharmacists believe they are the ‘gurus’ of medicines. It is quite common for them to ‘query’ a physician’s prescription just to show that they have more knowledge about drugs.

Large egos in hospitals are often manifested as arrogance. Ego and arrogance are offensive to everyone and are major causes of in-fighting in the medical team.

Lack of Mutual Respect

Furthermore, healthcare professionals do not show enough respect for others on the medical team. Unfortunately, until there is mutual respect exhibited in words and actions, disharmony and disunity may continue.

In a male soccer team, there can only be one captain. However, the captain alone cannot be a midfielder, goalkeeper, striker and defender all at once. He needs others to make the team victorious. He may not be the most talented though, but he is the captain and deserves respect. He must respect others too. He must not be condescending in speech or conduct towards teammates. They are actually teammates and not subordinates. They are also endowed with skills, talents and knowledge.

If other healthcare professionals were inconsequential, society would not have placed them together with physicians in the health sector. Teammates must each recognize their role on the team, fulfill their responsibilities and respect their captain.

Fight for Resources

The leader of any team usually controls the allocation of resources. It is therefore little wonder that every member of the medical team wants to lead the team. If the leader allocates resources unfairly or unjustly, there will be in-fighting. This fight is actually a fight for prominence and relevance. Team Leaders therefore should be just and fair in their leadership roles to reduce the incidences of discontent among team members.

Bias in Training

Most of the problems probably began with the training of healthcare professionals. It seems they are all trained to believe that they are invincible. In the various sectors of medical training, lecturers consciously or unconsciously transfer their centuries of in-fighting to the next generation. The biases and misconceptions in relationships sometimes ‘sneak’ into medical training. Statements like “the doctor is king” or “doctors want to steal the jobs of laboratory scientists” help to reinforce the disunity among medical teams.

It is not surprising that when these professionals start working together, quarrels occur because of underlying grudges. Will it be too difficult to introduce courses like “Team work” and “Team Management” into the medical syllabi across board? Will it be too much to bring together students of all health sectors to interact both formally and informally while they are still in training? That way, when they graduate they will probably be able to stand the sight of each other.

Teamwork is a problem in healthcare and we should not let it remain so. If we keep up this childish, egocentric and prejudiced charade, our beloved patients will continue to suffer.

There is a lot of work to be done. Let’s roll up our sleeves and get to work. Maybe, just maybe we will be able to do what our medical ancestors could not do - work as a united team.

Cheers!