Quote from John Freeman on July 25, 2023, 7:50 am

Hello,

at work there's a colleague who's also an attending, Peter. He's generally a kind and smart person. He's also very power-aware and good with power dynamics.

4 days ago I sent an email to our staff physicians and attendings, so basically the executive team. The email was a question regarding whether or not to do a certain urine exam in a patient. At the hospital there was a lot of confusion around this exam. The gynecologist head of service from gynecology said that this exam was not needed and it was a waste of money. He said it to the midwives during a meeting. So I got two calls from the midwives about this exam to challenge me (us) on this exam since they were now empowered by another physician to challenge us. I explained both times why it was necessary. Then I talked about it with one of our staff physician who's specialized in this matter (newborns) and he agreed with me.

3 days ago, I receive an email from my attending colleague (we are 3), Norbert. He said to me that he was the one to say in the first place (he worked the day before me so said it before I contradicted him without knowing, we work in shifts so it changes from day to day) to midwives not to do the exam. So I sent a question through email to our staff physicians and to Peter and Norbert. The goal was that we would be all on the same page when such a case was going to happen again in the future. To avoid these discrepancies between us. I protected Peter's identity by saying that "some people in our team have a different opinion" when asking my question (so it could even have been a resident). All staff physicians agreed with me, including the one specialized in neonatology. They sent us an article and he gave an elaborate answer. So my question was value adding to the team as we all learned. Even other staff physicians as the one specialized also taught them things they did not know. So far so good: team-work, value addding leadership from my part, synchronization.

2 days ago was my day off and Peter leaves me an audio message on WA telling me about a supposed mistake that I did. Basically, that the child in question is not as small as I calculated. It's a mistake from his part. I verify and send him that my calculation is correct. So here there is a slight crossing of boundaries as it's my day off but at the same time if he waits to answer or I wait to answer, the child would already be home before I go back to work on my next shift. So it's a bit of a grey area. I do answer on my days off since it's how to make the work move forward. If I have too strong of boundaries on my days off the work suffers for my colleagues due to the shift work nature. The thing here is that he tries to correct me whereas he was in the wrong. So basically here factually I asserted what was right. I minimized my investment but still answered.

Yesterday, he leaves me another audio message on WA. This time it's about an adolescent with huge mental issues. Basically, it's a suicidal adolescent who comes now every other week to the hospital because of a suicide attempt. The problem is that we're not a psychiatric hospital. So we're not equipped to have her there. There are sick babies, mothers, etc. So we have to hire a security guard and it's the hospital which is paying, not insurance. So it's a net minus for the hospital and a big one in addition. More on this later. This adolescent came 1 week ago for a suicidal attempt. I was there and proposed to the child psychiatrist and our staff physician to organize a meeting with all people involved as we're in a vicious cycle in this situation. They agreed. So I sent an email to the staff physicians and my colleagues to know who would like to go to this meeting, while saying that I was available to do so. One of the staff physicians answered he would come. So far so good, I'm working tomorrow so I can now do the doodle with the other people involved (foster home, child psychatrist, etc.).

Going back to his message, the adolescent did another suicide attempt.

Him: [blablabla] Staff physician told me you initiated this. I leave you the hand to send the things to the different people.

Him: if you're motivated, I let you do it.

The thing I did not like is that he said "I let you do it", framing him as tasking me about something that I initiated and am currently organizing and leading.

For additional info, he tells me that it cost $3000 per day (!!) for the security agent. So he gives me this info which is useful.

So in this situation I thought about counter-tasking him. But I felt it was too much of a small thing. Plus, it was not public so no loss of status.

So I just put a "thumbs up" on his message, which is very low investment. What I don't like is that despite us being equals he's more and more trying to cement the reality where he's above me whereas in the group, I'm considered by the staff physicians as the leader of us 3.

It's not an ego thing. It's based on the fact that since I arrived 3 months ago, I tidied up our common office, I re-organized it. I also launched several projects, some of which I finished (email list to reach specialists external to our hospital) and some of which I am still in process of doing (guide to write a hospital letter for the residents, will save time for them and us). I have other projects and propositions in the pipeline. I also proposed several topics to work on for our next attending-staff physician meeting. I asked my colleagues their input on them and they agreed. So just through my desire to make things move forward and improve the service, I stand out.

So I feel like he's trying to social climb on me.

I'm happy to read if you guys have any comment on this.