Hospital AdministrationMedical Education

Doctors and Nurses: Doctors need to Order Less, Listen More

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doctors and nurses physician leadership skill listeningDoctors and Nurses form a TEAM in healthcare.

Often that team is quite dysfunctional because of a basic cross wiring in the command and control of the team.

A post on KevinMD.com last week hit a nerve. It was titled “Listening to Nurses is a Key to Being a Good Doctor”. I couldn’t agree more.

Think about the average hospital situation …

  • How many minutes a day does the doctor spend with the patient?
  • How about the Nurse?
  • The nurse’s aides?

Given that imbalance of simple time with the patient, their symptoms and their responses to your therapeutic interventions – who knows more about the patient … the doctor or the nurse?

And how often are doctors curt, dismissive, in a rush, don’t listen to input from other members of the care team or just flat out don’t ASK the nurses what they have noticed. 

Doctors get no training on team leadership and are notoriously horrendous at listening yet their relationship with the care team is described as “Writing ORDERS”.

Outside of medicine, the only place the leaders give orders is in the Military. Generals know who is doing the fighting and don’t mistake front line intelligence with wall maps back in the command post.

Here’s a quote from “Kill as Few Patients as Possible” by Oscar London, MD:
“Working with a good nurse is one of the great joys of being a doctor. I cannot understand physicians who adopt an adversarial relationship with nurses. They are depriving themselves of an education in hospital wisdom.”

I agree with the author of the post at KevinMD (a neurologist blogger, calls himself “Doctor Grumpy”).

A sign of a quality doctor, who values the contribution of his team members and has some team leadership skills is this

  • How little they talk
  • How much they listen
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