How Do We “Gather Together” When We No Longer Do?
“One of the gifts of 'Star Trek' is my professional work colleagues have become my lifelong friends.” George Takei (Hikaru Sulu)
Recently it occurred to me as I was reading a series of consultant notes over the course of a clinic day that I did not know any of the 10 subspecialty colleagues whose notes I was reading. Though I recognized most of their names, I would have no idea what they looked like if I passed them on the street – or in the hospital. I don’t even know what their voices sound like. Which left me wondering, what does it mean to be a “colleague” in 2023?
In my “medical upbringing,” it was instilled in me that collegial familiarity across specialties was an essential component of effective patient care. Well, it's been quite some time since I gathered with fellow physicians outside my own department. This does not seem to be simply a symptom of the pandemic, but of the impersonal way much of healthcare is now delivered in many parts of the country. Perhaps my training regarding the importance of this interspecialty connection is just a nostalgic remnant of “times gone by” rather than a vital ingredient for providing quality patient care?
A newly published study might provide some clues. The authors sought to determine whether having some historical connection between the primary care physician and subspecialist, in this case an overlap in professional training at the same institution for at least 1 year (which they called co-training), might have an impact on patient care quality compared with those who had no such co-training. The study design didn’t determine whether the physicians even knew each other or were aware they co-trained.
Using a patient experience rating of specialist care, the authors found that co-training was associated with a more friendly and concerned manner, clearer explanations, greater engagement in shared decision-making, and changes in prescribing by the specialists. While acknowledging the study limitations, they concluded that there existed the potential for significant gains in care quality by encouraging and harnessing interspecialty physician-peer relationships.
But how do we do this? At a time when regular physical (or virtual) gathering may not be practical or even desired, how might we gain more familiarity and connection with those whom we regularly share in patient care? This question takes on even greater importance if our present structure is truly creating poorer quality of patient care. The literature provides few answers. So this week, I’d like to tap into the collective wisdom of our PeerRxMed community. Please take a moment to send your thoughts to mhgreenawald@carilionclinic.org and I’ll follow-up with a summary in future blogs. In the meantime, why not do an experiment this week and reach out to thank an interspecialty colleague who is sharing the care of a patient with you. Doing so may positively alter the care of that patient. Another reason why no one should care alone.