I have practiced medicine since 1978, first as a resident and fellow, then ... well, yada, yada, yada. In my experience, I have observed that very few physicians used to falter because of a lack of intellect or a major deficit in technical skills. Nowadays, however, we seem to have some real rocket scientists (NOT) in our ranks. However, a few that are not successful in their practice have difficulty because of poor professional behavior. Medicine demands an exceptionally high standard of professionalism, and I offer the following A-Z primer as a reminder of a few rules of good behavior in medical practice, specifically practice for the OB-GYN.
A is for arrogance. This is the stuff of SURGEONS. Although we in ob-gyn are considered surgical subspecialists, we are NOT real surgeons. Therefore, we are not entitled to the right of arrogance. Pure and simple. While some GYN oncologists border on being surgeons, and as such can be arrogant a little bit and on occasion, the rest of us must NOT try to be surgeons. We're just gynecologists. [This does not apply to ob-gyns who are chairmen - arrogance is a job requirement for them.]
B is for benevolence. Dictators can be benevolent. Gynecologists are doctors. Where did this come from??? I've never heard of a gynecologist who was a dictator. [Exception: the chairman – see above.]
C is for compassion. Compassion is what we have nurses for. It's not our fault that RNs all want to be nurse-administrators and wear high heels and business suits and push paper. We can't do their jobs for them. Write the orders, get in your car, and get to the office!
D is for dogma. Remember that it's a short trip from DOGMA to DOGSH*T. If someone tells you they do such-and-such because that's the way they always do it, or that's the way their teacher always did it, WATCH OUT. There's always someone lurking with some RCT from the New Guinea Journal of Zoological Astrophysics that says what you're doing is NOT evidence-based. And he'll pass that along to the lawyers... Always think of a scientific excuse for what you're doing. [Exception: Chairmen do what they're doing because they're chairmen - no other excuse is needed.]
E is for an even temperament. Remember, the more even and predictable your are, the easier it will be for an assassin to get you. Always act differently, take a different route to the office, and generally keep a low profile. Remember the word NINJA and you'll survive longer. Importantly, medical records personnel are ALWAYS the ones to find you - be suspicious of them.
F is for fair minded. Be fair in your dealings with insurance companies. Those that hold your payment the longest, charge the most. If they complain, there's a class action suit in the Federal Circuits that you can join...
G is for good humor. Always laugh and appear jovial. That way, when something bad happens, no one will realize it until you've had a chance to leave the OR. [Exception: A chairman is only jovial when he's doing something bad to you - HE'S not leaving... take a hint.]
H is for honesty and humility. Always tell the truth. Just be damned sure that you don't tell the truth to the wrong person! Humility, on the other hand, is for INTERNISTS. They can't operate, and they know it. They need to be humble because... well, just because they should be. They thought they were so damned smart in medical school and... well, you know. [NOTE: If one is honest and humble, one will never be a chairman.]
I is for insight. Always keep an eye on your partners. They are probably scheming to do something bad to you, even if it's just an embarrassing birthday party when you turn 50 or something. [NOTE: Keep TWO eyes on the chairman... he's scheming as part of his job description.]
J is for judgment. Avoid judgment at all costs. Stay out of court, stay out of credentialing hearings, stay out of ANY forum where anyone can judge you. They will ALWAYS find something wrong, because if they didn't, they'd be out of a job. [The chairman? Don't even go there...]
K is for knowledge. As always, it's not WHAT you know, but WHO you know. 'Nuf said.
L is for listen. You can learn a lot by hearing the nurses' whisperings. See "NINJA" above.
M is for modesty, a trait that complements humility. If you look too flashy or attractive, SOMEONE will be jealous, and they'll probably be on some committee somewhere (see "JUDGMENT" above.)
N is for negativism. Underscore this: NO negativism!!!!
O is for open mindedness. Remember to be open to new and wonderful things. Any friend can stab you in the back, and your worst enemy may end up a valued ally (although you don't ever trust him, you can still get some mileage out of him...) [NOTE: Chairmen are forbidden to exhibit open mindedness. See DOGMA above...]
P is for promptness. Always be home on time. Your spouse and/or children must be kept happy, or they'll hound you to death and keep your from sleep. Also, you don't want to get a cold dinner (except pizza, which is actually good when microwaved).
Q is for quizzical. When asked for an opinion, always give a quizzical look and keep on walking. If someone pins you down on any given question, it can be used against you later. (See JUDGMENT above, and also NINJA.)
R is for reliable. Always keep your car reliable, in good repair (unless you're one of those damned Europeans or Manhattanites who can ride busses everywhere). Since most hospitals and other healthcare institutions won't let you carry a gun, your car is your next best friend. It will get you out of trouble, get you to the bank, get you to the golf course, etc. if you treat it well. Name your car a name and keep her (or him) clean and running smoothly. (P.S. Do NOT name a car CHRISTINE, and do not name a car after your chairman.)
S is for sensitivity. Feelings - nothing more than feelings....
T is for tact. Never tell anyone what you actually think of them. They may be (1) on a committee (See JUDGMENT, above); (2) a future chairman; (3) a future spouse; (4) a federal undercover officer; (5) a member of Al-Quaida.
U is for user friendly. Make sure you use a MACINTOSH. Windoze sux, and the rest are just plain hard to find parts for.
V is for vigor. No, it's really for Viagra. All the patients want it, so just give it to them and they'll probably pay cash.
W is for work ethic. Make sure you farm out as much of your work as possible before you start on it yourself. After all, it interferes with your working to have to call people and ask them to do this or that. At home, give assignments out to the kids BEFORE you lock yourself up in your office and turn on your computer. [NOTE: Chairmen have... ah, well, you can figure THAT one out yourself...]
X is for eXacting standards. No it doesn't. It stands for Xenophobia. No one likes a stranger. So never go somewhere else. Always stay in your own briar patch, and FIGHT LIKE HELL if someone tries to kick you out of it. In the old days, you could SHOOT varmints who tried to run you off the homestead. Oh, to bring back the good old... (snip)
Y is for yourself. Always think of yourself first. If you don't keep yourself happy and in good working order, you won't do anyone else any good. This is so elementary, it's amazing that no one knows about it.
Z is for zero tolerance. Don't be tolerant of zeroes. If someone can't pull his own weight, wash your hands of him. You can't be expected to do everyone else's work. Also, if you persist in hanging out with zeroes, when the chairman or the committee (or the nurses) finally decide to "take him out," you may get hit as acceptable collateral damage.
I conclude with several simple suggestions:
(1) always wear clean underwear with no holes (includes bras)
(2) always brush your teeth (includes tongue)
(3) if red lights go on in your car, GET THEM LOOKED AT
(4) be kind to animals - they're the only real friends you have
(5) it's okay to wear fur - the animals are already dead, use them
(6) it's okay to eat meat - ditto
(7) adult dose of furosemide IS REALLY your age plus your BUN
(8) remember, people working at fast food restaurants REALLY ARE
liberal artsy people - don't expect them to know math
(9) smile at children
(10) look in the mirror - this is how people see you