Checking your ego at the door

I’VE ALWAYS THOUGHT OF MYSELF AS A TEAM PLAYER. BUT FROM MAY 2 to 5, 2007, at the “Strengthening the Bond” Tri-professional Conference: Collaborating for Optimal Patient Care in Banff, Alberta, I found out that I’m not. You too, my dear colleagues, may be at risk of suboptimal team work due to subconscious narcissistic properties. Most pharmacists can think of times when they have clashed with other health care professionals. I have told my story about a physician who told me to “f—— off” as I pointed out a potential drug interaction or the one about the patient’s nitro patch taped to her arm because the nurse forgot to remove the backing. I’ve spent many hours entertaining my colleagues with stories of these antics and I’ve listened and laughed along as they regaled me with their hilarious tales of health care hijinks. Then I went to Banff, along with over 650 pharmacists, physicians, and nurses to attend the first interdisciplinary conference of its kind in Alberta and my perspective suddenly changed. The conference opened with speaker Yvonne Camus, who was the only female member of the 4-person Canadian team sent to Borneo in 2001 to participate in the World Champion Eco-Challenge Games. She stood before the audience and admitted that she had been the weakest part of that team. Now, I was part of the conference planning committee and my first thought was “why would we hire a motivational speaker who admits to being the weakest part of the team?” It seemed counterintuitive when the audience was full of professionals who are considered to be leaders merely by holding a conference like this in the first place. But as Ms. Camus pointed out, it’s not about who leads the team, but about working together toward an ultimate goal. That means that a team doesn’t revel in the flaws or limitations of its individuals, but that they assist and empower each other to achieve success. Although we say we are team players who want to collaborate for optimal patient care, I wonder if that’s what we really want. We are taught, mentored, and examined on our abilities to communicate, implement, and recall knowledge and skills under stressful situations, but are we ever really taught to accept and educate our colleagues and ultimately overlook any shortcomings they might have? Our universities now teach interdisciplinary courses, but their students face obstacles that they may not even recognize when trying to implement these practice models upon graduation. Dr. Zubin Austin, a professor at the Leslie Dan Faculty of Pharmacy, University of Toronto, spoke about the idea of professional cultures and interprofessional communication and how this influences our ability to effectively collaborate. We may not realize that our professional education is a form of enculturation, resulting in very distinct cultures existing in medicine, nursing, and pharmacy. He also explained that although our professions may be separated by relatively small “cultural distances,” there may be relatively large differences in our patterns of communication. One example, the lack of a common definition for “taking responsibility,” Dr. Austin explained, is at the core of the professional-patient covenant, but there are conflicting ideas of what “responsibility” means in a legal, ethical, and personal sense. This should be clarified so all members of the team share its common understanding. Ms. Camus had pointed out to us that “it’s the small things that will bring any team down.” In order for us to improve our interdisciplinary collaboration, we need to overcome the stereotypes of our colleagues and admit that we too have weaknesses. As heard throughout the conference, the traditional approaches to patient management need to change and we can start by accentuating our colleagues’ strengths rather than focusing on their shortcomings. If we’re always trying to be ahead of our colleagues, then we’re not focused on making the team better. In the words of another speaker, Dr. Mamta Gautam, “We cannot entirely change the health care system. We can establish a supporting and collaborative work environment within this system. We are all on the same team and have the same goal.” I’m happy to dump my ego for that.

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