How to get along with your Attending physician

Attending physician and nurse practitioners working together

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It’s a fact of nature that no one is going to tell you during the interview process that you are going to be working with a “challenging” Attending physician or collaborating physician.  I say challenging, but there are many terms used to describe them. For instance, other terms include: “strong personality”, quirky, unique, and just plain difficult. They may also be described as “having really high standards for nurse practitioners and advanced practice providers”. I think you’re starting to get the picture.  Here we’ll explore ways you can get along with and dare I say enjoy working with your Attending physician.

1. Clarify expectations.

Clarifying expectations for your role on day 1 is hands down the best way to start off on the right foot. Nothing leads to frustration faster than not knowing what the physician expects of you and vice versa.  On day 1 schedule a meeting to discuss their preferences for how they want their clinic to run.  How much autonomy would they like you to have? Will you have your own follow up clinic? Are they the divide and conquer sort or a let’s just keep it together type? Also, let them know your strengths and how you think you’ll be most helpful. This will prevent a lot of pain and tears down the the road.

2. Show an interest in learning.

Most Attending and collaborating physicians love to teach.  Show an interest in learning and mastering the specialty.  Recognize your own limitations. Soak up the knowledge they are providing. Do your research and read the articles that they’ve published.  The same goes for books. Ask if you can help with their research. This can be as easy as reviewing charts and data entry.  When they are showing you skills, pay attention.  Disinterest is unprofessional, dangerous, and will only strain the relationship. 

3. Be professional.

It goes without saying that if you show up to clinic late and unprepared life is not going to go well.  Always be on time or better yet adopt the military way and be early.  Prepare for clinic ahead of time and review your cases for the day.  Respond to pages and emails promptly. Don’t be lazy.

4. Be kind.               

Always take the high road and be kind even when others are not.  Sometimes people just have a lot on their plates and they may not respond well to stressors that day.  Try not to take it personally and give them a pass.  Remember your main objective is to take care of patients. So stay patient focused, not wondering why the physician was short with you that morning. The only caveat is noted below. If you find yourself exposed to persistent abuse or verbal attacks, please see below. 

5. Build trust.

Building trust can take a while. In most instances it takes a full year for a nurse practitioner to acclimate to their new role or specialty.  It takes time to build the relationship with your Attending physician. The best way to build trust is to be reliable, responsive to calls, pages, and texts.  Let them in on your decision making process when taking care of patients.  They just want to know the way you think and how you would approach a problem.  Once they know that you’re on the right track, they’ll begin to trust you.  If you make a mistake, own it.  Let them know that you’ve made a mistake and what you’re going to do fix it.

6. Know when to involve management.

Involving management can often feel like your tattling. But, this isn’t the case. If you are finding that none of the interventions above are working and somehow the relationship is more strained than ever, then it’s time to involve your supervisor or manager.  Ask them for assistance on how to manage the situation.  More than likely, they’ve dealt with this type of issue before and understand the challenges that you’re facing.

7. Advocate for yourself.

If you find that you are the victim of abuse and degradation, involve your supervisors immediately.  It can be difficult to come forward, but like I mentioned above, often times this won’t be the physician’s first offense.  Most hospital and clinic cultures are strongly against physician abuse, especially at teaching hospitals. If this occurs, contemplate the hard work you’ve put into learning your specialty and becoming proficient.  Make a case for staying and finding a workable solution. In some cases, this may mean changing your physician assignment.

Women working together on laptops

This post has been about how to get along with your Attending and collaborating physician.  Building a relationship with your physician is essential. Learn tips on how to navigate these murky waters. Remember that your objective is to provide the best patient care possible and to do that you’ll need to be proactive.

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