Today in the chart
Seven Strategies to Try When You Butt Heads with Your Collaborating MD
A job in healthcare means navigating challenging relationships. For many APPs, working with a collaborating physician tops the list.
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Healthcare settings are packed with complicated relationships, whether theyâre between providers and patients or within the care team. One such dynamic that can be uniquely challenging is the collaboration between advanced practice providers and collaborating physicians. Why? Because their responsibilities and work are often shared.
âIn some states, MDs need to co-sign your chart, and you need to talk to them about the treatment plan,â explains Andrea Lowe, MHA, PA-C, director of employer strategy at the American Academy of Physician Assistants. âYouâre both deciding on meds, what course to take â together, youâre deciding whatâs best for the patient.â
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If you struggle to form a fast partnership, the nature of the work certainly raises the stakes, but many APPs face this. Here are some tips, based on Loweâs 20 years of practicing medicine, that yield significant results.
Communicate Early and Often
This is most important, says Lowe, because âeveryone has their own practice style. There are different ways to come to a diagnosis or treat a patient that has the same outcome.â (She adds that itâs crucial to communicate with everyone on your care team, not just physicians.)
Whether youâre working with someone for the first time or youâve butted heads in the past, itâs okay to ask how that person prefers to work together. Perhaps you can offer to see patients with the MD as a duo or to do it alone and report back your findings. You can also go a more general route and simply say, âWhatâs your style?â
Be Willing To Pivot
Part of working on a healthcare team means dealing with many other peopleâs opinions, not just MDsâ. As an APP, you might work a 12-hour shift, eight of which are with one physician, the rest with another, who may have a different workflow or approach to cases. When that switch happens, be ready to accommodate a new approach.
Ask Why Someone Wants To Do Something a Certain Way
At first, this might seem unnecessarily confrontational. Still, if you donât understand why the physician has made a specific decision, you should say so while being mindful of how you pose the question.
For example, Lowe has asked, âCan you walk me through why you want to do it this way?â successfully. âIâve found that Iâve been wrong, and something didnât occur to me,â she says. âFocus on the why behind the difference of opinion and course of action.â
Drop Your Ego
When you donât agree with the physicianâs reasoning, itâs best to âagree to disagree,â Lowe says. âArguing wonât get you anywhere.â
If you have a particularly challenging interaction, consider pulling the individual aside and saying something non-confrontational. A direct comment like, âIs there something youâd like to discuss?â can work wonders.
Remember, the Patient Comes First
When you have difficulty letting go of a situation, remind yourself of your responsibility to the patient. âIn medicine, itâs not about being right all the time because that will lead to mistakes,â Lowe stresses. âYou do whatâs best for the patient.â
Focus on the Positives
âIâve had some colleagues come to me and say, âDoctor So-And-So has a very strong personality,ââ Lowe recalls. âBut Iâd point out to them that his patients love him. You must see beyond that and understand that he wants whatâs best for the patient.â
Reframing the dynamic can help you refocus on patient care because, at the end of the day, as Lowe explains, âyouâre both there to do a job.â
Stay Confident in Yourself â And Your Profession
Youâve likely heard criticisms of APPsâ increasing practice authority, whether theyâre online or at your workplace. Lowe stresses that you shouldnât concentrate on the negativity but use it to educate others about the role of APPs.
âYou graduated from PA school and passed your boards because youâre smart â donât let anybody take that from you,â she asserts, adding that conflict in healthcare happens across the board, not just between APPs and MDs.
âRecognize that youâre a part of a team,â she advises. âBe open to doing things differently and get yourself a seat at the table ⌠[APPs] arenât going anywhere.â