What if Doctors and Nurses Could Support Each Other?

By Marjorie Stiegler on December 4, 2015 in Leadership, Patient Safety and Quality, Teamwork

A flower does not think of competing with the flower next to it. It just blooms. Baruch Spinoza

This week, KevinMD will be publishing a post I wrote about inter-professional hostility in healthcare.  I thought I would share some of the inspiration for that post here.   Is there really an escalation of  ‘scope of practice’ conflicts and a downward spiral of disrespect, or is it just more palpable in the modern era of anonymous comments and viral online posts? I don’t know for sure, but lately, the conversation seems louder to me.

epidemic of disrespect in healthcare

Do doctors have to be bad in order for nurses to be good?

(Image source: Facebook.com/WeAreNurses and www.nursebuff.com)

In my KevinMD post, I talk about physician-physician hostility as well. And while often shrouded in humor, this kind of mindset is a real threat, not only to personal and professional satisfaction, but possibly to patient safety, as it impedes open communication and mutual trust.

These kinds of barbs have been flying since at least my first day of medical school in 2003, but I’m sure they go back much further.  Why is it necessary to put one group down in order to assert one’s own value?  This doesn’t make sense.   Skill speaks for itself.  This good/bad tactic is unnecessary, and reflects poorly on those who create it.  Worse, some official organizations (below, the American Association of Nurse Anesthetists) chime in with outrageous propaganda containing wildly false (sundown rule?) and offensive (we treat expectant mothers as second class citizens?) assertions:

The AANA says that anesthesiologists don't take call and won't give epidurals without cash upfront

I won’t hide that the ASA has their advocacy material as well.  Here’s a sample:

The ASA pushes back against independent nurse anesthetist practice

Quality measures, expertise, and skill of any individual is tangled up in the machine of the perioperative experience. It’s tough to measure.

Patients are complex. They show up with a host of pre-existing problems (some known, and some yet to be diagnosed), have an operation that may be short or long, big or small, have good luck or bad, and receive care from probably at least 20 different clinicians during their stay, all of whom are most likely well-trained and well-intended.

Patients are sometimes resilient and get better even when we make mistakes, and patients sometimes are so ill or injured that they simply can’t be fixed even when everything is done right.

And to some degree, it is irrelevant.  I don’t need a study comparing one kind of doctor to another, or doctors to nurses, to know that all of us are worthy of basic human respect.

nurses vs doctors

Nurses are critically important. Pharmacists are critically important, as are dentists, therapists, aides, technicians, and – dare we say it – doctors are too.

My respect for others is not based upon hours or years of training, number of nights and weekends sacrificed, or initials after our names, even though they may indeed be different.

Here’s one thing I know with conviction: we all have value. It is not necessary to marginalize each other to take pride in our own worth.

What Paul says about Peter tells us more about Paul than about Peter. Baruch

Have we forgotten? We all exist to help patients, not to put each other down in some kind of battle for supremacy.

I come to work to take care of patients to the best of my ability. I can’t do it without the rest of you, and from time to time, you can’t do it without me.

We are all in this together.  Let’s start acting like it.  Please join me by leaving your comments below.




  1. Ray Collins December 5, 2015 Reply

    I get your point, of course, both here and in your KevinMD post. That said, I don’t leave my wife in a hospital where I don’t trust the nurses. There is a big difference in that respect between the two hospital systems here. In one the nurses are trustworthy, in the other morale is in the toilet along with attitude and performance. Both systems contract with the same two agencies furnishing hospitalists, all of whom have been poor performers with issues ranging from minor to serious. If the issue with a hospitalist is serious enough, I talk to a charge nurse, and so far they have solved any problems I or my wife can’t handle in direct interaction with the hospitalist.

    • Author
      drmstiegler December 8, 2015 Reply

      Thanks Ray! You are right – I get really concerned if the charge nurse can’t or won’t help resolve a problem. I have had several recent close encounters as a patient and as a family member of patients. Some were fabulous, and some were downright scary. In both cases, the vibe seemed to be across the board in their respective institutions – doctors, nurses, and other staff equally as wonderful or as questionable.

  2. Sean.Dent December 7, 2015 Reply

    PREACH IT. Warms my heart to know there are still advocates out there. We all should recognize our differences and respect them, but they should not define us. And surely not an excuse to point fingers.
    We’re in this together, our patients need a medical TEAM to care for them.

    • Author
      drmstiegler December 8, 2015 Reply

      Yes! Thank you for commenting. We are different – that is wonderful – more perspectives, and all deserving of respect.

  3. tom combs December 7, 2015 Reply

    Medical care is a team sport – and immensely challenging. No one does it alone.
    The healthcare professions suffer enough doubt, lack of appreciation, and misunderstanding without heaping it on one another. The comments putting down others (both within and between caregiving fields) drags us all down.
    Even if some among us don’t see us as one team the public and patients do.
    Nice article!

    • Author
      drmstiegler December 8, 2015 Reply

      Thanks Tom! Appreciate your comments. Totally agree.

  4. Christopher l aaron December 8, 2015 Reply

    Christopher Danielson Aaron
    4 mins ·
    I can honestly say from the physicians side of things that many could have learned a thing or two in kindergarten… Hubris runs rampant, entitlement is endemic and many are machiavellian and narcissistic…there is a physicians and medical student web site called “student doctor . Net”, i have perused this site on occasion (and made the mistake of posting before) and ill tell you, the trolls jump all over you if u ask for any kind of advice. Many on here ate suspicious of you for asking simple questions. I had a question about getting bak in to a residency a couple of weeks back. The posts were brutal: why have u been gone so long? Why should anyone take you after yor prolonged absence ? Wat ru not telling us? There must be red flags in your history? Some were very hostile and pejorative. I closed my account after 7 years. Its crazy. The hostility i have witnessed at this site makes me ashamed to be a physician… Many go there bc they are anxious about the state of medicine, feeling burnt out, or bc they are worried about getting a residency etc. wat most meed is just a sympathetic ear or some inkling of solidarity among their chosen profession. However, it doesnt take long for the wolves to inevitably pounce on these people… Go check it out sometime, its alarming. its an anonymous site so there is no accountability…. Im almost positive that some the suicides we have seen among health care workers as of late r a direct result of the bullying on this site…. Im debating writing an article about it

    • Author
      drmstiegler December 8, 2015 Reply

      Thanks Christopher – I have also noticed that anonymous sites can be especially hostile. So much is casually thrown at others that I highly doubt one would say to a stranger’s face!

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