For most, middle school is a distant
memory. You might have
played jump rope, or you might
have played doctor. And along
with the schoolyard routine came
our education in etiquette. “Don’t
interrupt.” “Wait your turn.” Our
world is built on the standards of
being polite. Surprisingly, healthcare
providers tend to overlook
these simple rules when it comes
to collaborating with one another.
It becomes all the more relevant
when you account for the increasing
complexity of healthcare demands.
These days, chronic diseases like
diabetes, obesity, and cardiovascular
disease are on the rise. In order to
provide effective patient care to individuals
suffering from these illnesses,
you need a diverse team of healthcare
professionals. That’s where interprofessional
collaboration comes in.
Take the example of type II diabetes.
Effective care would require
patients to be prescribed medication,
understand the physiology
of their disease, and adhere to
dietary and lifestyle modifications
to self-manage their condition.
This requires collaboration between
a minimum of three healthcare
disciplines to take advantage
of their respective specialties: a
physician, a nurse practitioner,
and a dietitian.
Yet incorporating the different
perspectives of each professional
isn’t as easy as it sounds. In fact,
part of the conflict arises from
healthcare providers having their
own unique perspectives. Professionals
train to practice in a specific
field: they learn a different set
of customs, values, and behavioural
norms specific to their discipline.
Then comes the question of
which disciplinary perspective
will dominate the conversation.
For example, nurses tend to dominate
when faced with dieticians
and social workers. Research has
shown that nurses tend to adopt
a competitive style when interacting
with other healthcare staff, imposing
ideas and being impatient
with the process of gathering information.
Strangely enough, most professionals
don’t even realize they’re
acting this way. In a study conducted
this year by Lorber and Savic,
hospital employees rated nurses as
having dominant behaviour styles
when dealing with conflict. Nurses,
on the other hand, rated themselves
as agreeable and compromising.
But interprofessional communication
isn’t just about who talks the
loudest. A distinct hierarchy exists
within healthcare settings, and it
often determines who will be heard.
Unsurprisingly, doctors usually
get first place in the healthcare
pecking order. They exercise more
power over decisions related to caring
for patients, thanks to their extensive
medical knowledge. Other
professionals tend to accept and
follow this hierarchy, despite feeling
that their own concerns and opinions
are undervalued.
To make matters worse, most
healthcare professionals have minimal
knowledge of the skills other
fields can contribute to patient
care. As scientist Marie Lidskog
and her colleagues explain, this
leads to stereotyping the social
identity of other professionals. The
resulting lack of mutual respect
makes it understandably difficult to
collaborate on the task at hand —
namely, the patient’s health.
That’s where it becomes clear
that all this squabbling is somewhat
counterproductive. When it
comes to caring for a patient, the
best solution is collaboration.
Researchers in the field have suggested
ways of overcoming these
disciplinary duels. They recommend
active listening, asking open-ended
questions to avoid one-word
answers, and using body language
to show respect for each member
of the healthcare team. Many suggest
that getting civility back into
the game is also a matter of pushing
docs off their pedestals, and giving
the underdogs equal standing.
Perhaps what our highly educated
healthcare professionals really
need is the lesson in etiquette we all
learned in middle school. Figures.
