Respect for Clinical Judgment

Jeanne,

You are welcome.  You're right - never too late to learn and grow!  I'd love to hear your thoughts on the book.  Oh, I got mine from the library - so it was free!  In this economy, every bit helps!

Thanks for the info Jane. I haven't logged on to the blogs in a while. Too bad I didn't have this book to read early on... like 30 years ago (!) but since I'm still "in the game", it's never too late to start... to read a good book, that is ;) .... and then put it to good use!

Jeanne,

That's what I've been doing on my blog - each week is a nutshell.  This week was week six, so we're almost done.  

The first week I explain the dysfunction:  what it looks like and its consequences.  The next week I describe the tools that a team can use to work toward healthy function in that category.  My Dec 21 blog(http://community.advanceweb.com/blogs/pt_4/default.aspx) lists the tools a team can use to work toward commitment.  

The problem is, you can't start there.  At a minimum you'll need to read the week before to get an understanding of what team commitment does and doesn't look like.  

Truthfully, to be effective you'll need to start at the beginning, which is Nov 9 (http://community.advanceweb.com/blogs/pt_4/archive/2011/11/09/team-dysfunction.aspx).  The reason commitment is a problem is because the previous two components are dysfunctional, preventing commitment from taking place.

Each function builds on the next.  You have to have the first in place before you can work on the next one.  Lencioni's book is an easy read.  I don't like to read and I made it all the way to the end :-)  I think I read a chapter a night and made it through in about 2 weeks.

Good luck!

The therapist's opinion was not considered in thi case. The team is not functioning in this case. I have been there.

 Jane, can you give us the "tools" in a nutshell enabling us to deal with these situations better? Some of us do not have the time to research all of this and would really appreciate some tips. Help!

Toni,

I hear your frustration.  Because of the series I've been doing, I'm seeing things a bit differently.  I'm not sure the core issue at play is actually the doctor's choice of treatment.  Patrick Lencioni wrote a book, "The Five Dysfunctions of a Team" which lends insight into the situation you describe.

Lencioni points out that it is not incumbent upon the leader (in this case the doctor) to do as the team members (in this case the therapist) say, nor is it reasonable for team members to expect to get their way.  As a team member, what is reasonable is to expect your opinion be taken seriously.  

Lencioni suggests that when a leader is skillful at relaying this sense that team members' opinions are being seriously considered, then team members can commit to the decision - even when the decision is contrary to individual team members' personal opinions.  This level of committment is called "buy in".  Obviously "buy in" isn't happening in the case you describe.  

There are various reasons this level of committment may not be occurring.  Some of them are covered in the last five weeks of my blogs.  Unfortunately, without team committment, higher levels of teamwork are unattainable.  Those will be covered in weeks to come.

Last week's blog on the dysfunction of team committment may offer additional insight into your sitation.  Patrick Lencioni's book, "The Five Dysfunctions of a Team," may give you and other team members tools you could use in interacting with this doctor.

Best,

After having practiced for many years and in various parts of the country, I have had the benefit of working in a team oriented practices/environments and the sheer frustratoin of working in a less progressive ones. Keep making your point, respectfully of course, and focus on the patient. You are not going to change this doctor or that type of thinking. That doctor may change when/if management does stand up! Trying to get management to step up is a whole different ballgame. I was not able to do that and it is why I chose to leave management behind and focus on the "hands on" in another setting . It has worked for me. I hope you have more days that are truly satisfying and experienes like you describe above lessen. Your passion comes through.