Tread Lightly When Commenting on Other Clinicians’ Capabilities—or Face the Consequences

Honest, respectful feedback can spur subordinates, superiors, and coworkers to do their best work. Comments that could be perceived as overly critical or, especially, bullying are both divisive and potentially harmful to all parties concerned, however. A recent blog post on the website DoctorDiscourse illustrates this in painful detail. It recounts how three physicians at three unrelated facilities lost their jobs or believe they were “blackballed” for seeming to discount the contributions or capabilities of advanced practitioners (ie, nurse practitioners and physician assistants). One of them was fired soon after writing an opinion piece for a local newspaper in which he noted his concern “about the implications that NPs completely replace physicians,” and that advanced practitioners are best utilized as “supervised physician ‘extenders.’” His article was in response to an earlier story published in the paper, titled “Are NPs Same as MDs?” Since he also wrote that the NPs he’s worked with were “well-trained, dedicated, popular with patients, and intelligent,” his dismissal on the grounds the he’d violated company policy regarding mutual respect among colleagues came as a shock. Another doctor complains that she lost her locum tenens contract after complaining that NPs she was supervising were providing care that exceeded their training. The third got in hot water for reprimanding a PA for what she saw as a violation of hospital bylaws in a way that was later deemed as too harsh. It all adds up to a cautionary tale for urgent care providers of every level: Regardless of your intent, carefully consider how your words and your message could be perceived, and ensure that your intention, tone, and language are not threatening or demeaning.