college connection
PROFESSIONALISM
their behaviour. If nothing else, the individual now becomes aware that their behaviour has been the cause of some upset, and he or she is afforded the opportunity to reflect upon that. They have received the gift of feedback. And, of course, reaching out to any recipient of hurtful or problematic behaviour is a caring and responsible thing to do as well. The same opening question works very well!
Being Responsible For Workplace Culture
I have heard culture defined as“ the way we do things around here.” Workplace cultures vary tremendously, described as collegial, respectful, fragmented, competitive, supportive, toxic, healthy, and so on.
And there are cultures within cultures where the social tone can vary widely and civility values seem to be at odds with one another. So often I have heard how the same veterinarian can be rude and intimidating in the operating room yet warm and supportive in the clinic. Learners describe different cultures as well, experiencing respect in some environments and belittlement in others.
Leadership is key. All veterinarians are leaders by virtue of their professional standing and the patient care dynamic. But it is the special responsibility of our designated veterinarian leaders, be they practice owners, academia, leaders of associations or species groups and others to understand their role in shaping and guiding workplace and professional cultures. Thoughtful, well-trained and collaborative, these are colleagues entrusted with creating safe and supportive professional environments. In such a workplace, any one of us can lead by seizing the moment, stepping up and forward when our senses and intuition tell us the time is right.
In these complex professional environments characterized by stressful political and economic changes, power imbalances, multiple agendas, technological evolution and revolution and so much more, civility as a shared responsibility might be the only way through.
Being Responsible For The Culture Of Medicine
The idea of memes as units of transmissible cultural information( like genes in a biological sense) is intriguing. It can be argued that there are a number of veterinary medicine memes contributing to a rise in incivility in the veterinary profession. Some examples include:
• A veterinarian’ s sacrifice of vital personal needs( e. g., sleep, nourishment, time with family) in the service of medical training and patient care is virtuous.
• Superior knowledge and technical excellence permits and forgives rudeness and other forms of incivility.
• The ultimate responsibility for patient outcomes lies solely with the veterinarian, thereby justifying any form of workplace behaviour no matter how it might affect co-workers.
I think of these as memes because I have heard about them, observed them and lived them, and others like them, throughout my career in medicine. They inform our attitudes and beliefs. They are modelled for us, overtly or implied, reinforced through training and practice, and passed along to each subsequent generation of veterinarians. But are they true? Unalterable? Which of our memes ought to be preserved and which ones require change? And continuing the metaphor, should the change be gradual and sporadic( as in genetic mutation) or sudden and deliberate( like infection or genetic engineering)? A culture of civility, like incivility, after all, can spread like contagion or be passed from one generation to the next.
Here, compassion, courage and humility are required. Do we care enough about ourselves, our colleagues, or co-workers, our workplaces and our profession to challenge our long-held beliefs that might not be serving us well? Our senior colleagues, seasoned by experience, may have a particular wisdom to offer.
The newest members of our profession carry with them modern personal and social
values that might improve the humanity of our profession. I submit that opening our minds to these perspectives, or any others that challenge our long-held cultural beliefs, will add to the civility within the profession while simultaneously enhancing patient care.
Conclusion
And so this phase of the conversation, a consideration of Five Fundamentals of Civility for Physicians, comes to a close. We end as we began, by questioning:
• Are we able to dig deep and find respect at the core of all of our professional behavioural choices?
• Will we learn, practise and teach selfawareness skills that will enable us to choose civility deliberately?
• How will we incorporate teaching of effective communication skills into all aspects of veterinary training and practice?
• Will we be able to elevate the concept of self-care from a good idea to a cultural value and professional imperative?
And finally, maybe most importantly, it is our responsibility to challenge ourselves:
• Who are we at work and what kind of individuals do we aspire to be?
• Can we improve relationships among colleagues and co-workers as members of our veterinary care teams?
• How do we come together to create the most grand veterinary profession imaginable?
Let’ s keep this conversation going. Responsibility is at the heart of a caring and civilized profession. Choose Civility
Dr. Michael Kaufmann is the former Medical Director of the OMA Physician Health Program and Physician Workplace Support Program. At a 2016 Council meeting, Dr. Kaufmann delivered a presentation on civility and explained the five fundamentals of civility for veterinarians. View the presentation at www. cvo. org / video.
Summer 2017 / 3