Old School New School: Who's driving this practice?!

When doctors clash, will the wheels come off the practice wagon? (Illustration by Ryan Ostrander)It's another sunny day, yet the waters seem a bit muddy as Dr. Codger steps into the office. Always first to arrive, he locks the door behind him so that he can get in some office time before the head receptionist gets things rolling.

But there's a nagging feeling of losing control that's been haunting the old vet ever since he gave young associate Dr. Greenskin maybe a little too much responsibility. (Read about it at dvm360.com/likeaboss.) You see, Dr. Codger believes there's a certain omnipresence and authority that must be maintained by a man of his position. And now he's feeling a little worried that the staff are sensing weakness in him. Was it right to just hand over control of something so important as hiring a new staff member? What's he going to give up next?

There's already some chatter from the lead technician about possibly changing one of the exam room posters without even talking to him. If that weren't devious enough, it's been rumored that the new kennel attendant has been using two pumps of dog shampoo for just about every bath.

Dr. Codger feels a bit like the wounded lion. And try as he might, he's having a hard time suppressing his natural instinct to take back his territory. No wonder, dear readers, that actually retiring is such a hurdle for this seasoned veterinarian.

Of course, some open communication might have helped. If you ask Dr. Codger, he'd tell you that regular staff meetings cover all of the important changes, and that he is being up-front and transparent about his searching for an exit strategy.

Talking with the team, however, you may hear a different story. Some might ask you to define the word "meeting." Others would be quick to point out that the last real get-together was more than three months ago, and only about half the staff were present because the hospital was too busy for everyone to participate.

Enter the blossoming associate ...

Dr. Greenskin, however, has continued building her confidence. The new technician she found has been working out great. Not only does the new RVT fit right in with the team, but she's also active with numerous dog-show organizations, and those contacts have been good for business. Dr. Greenskin's planning has worked out just as she'd hoped. The extra support is allowing her to handle more cases more efficiently, and she's been feeling like a "real doctor" instead of spending her time helping with technical duties.

So it's no coincidence that on the day that Dr. Codger is thinking too much about his loss of control, Dr. Greenskin strolls in feeling good at her usual time (after completing her meditation podcast and waiting in a very long coffee drive-thru line for a $6 mochiattasomethingorother). She smiles confidently and jokes with the morning crew while looking through the completed labs and preparing a strategy for her surgery day. She's been gaining so much momentum lately that she almost feels like she owns the place.

Enter the disgruntled practice owner ...

Dr. Codger walks into the treatment area, and he seems a little off to Dr. Greenskin. He's known to have a mood swing here and there, but this is out of the norm. Dr. Greenskin and two technicians do their best to give a smile and a "good morning," but boss man isn't having any of it. He starts in with a series of complaints and demands:

“Who left the oxygen running last night?! We're going to be down to one e-tank now for the whole day!

"Also, the cat ward is a complete mess. You better get the kennel people to take care of that immediately.

"Since our oxygen supply is so limited, surgery time is a real factor today. I'm taking the surgeries to make sure we don't have any issues.

"You can go ahead and jump in on regular appointments, Greenskin.”

Well, Dr. Codger sure got everyone's attention, and maybe not in the best of ways. He walks briskly toward the reception area to notify the front staff of the scheduling changes.

Dr. Greenskin isn't completely surprised by the outburst. She's no stranger to Codger's style, but she's left feeling a bit helpless this morning. As she has matured as an associate, Greenskin has done her best to avoid blaming herself for the day-to-day issues that arise. However, when her respected mentor so blatantly and easily points out things she should've noticed, her fragile confidence is shaken to the core. One second she was feeling up to the challenge, and in an instant she was completely deflated and left uncertain about how to proceed in life itself.

When doctors clash-if only in their heads

As she starts reviewing appointment charts, Dr. Greenskin finds it difficult to focus. Her thoughts are continually interrupted by negative self-talk and doubts as to whether she should even continue practicing veterinary medicine. Even the smiles and praises of her first two clients are not enough to put a spring back in her step on this day.

With ever-present tension throughout the hospital, the two doctors get through their day without so much as a nod to each other or a couple of mumbles about a patient's history. With such a difficult working environment, all are ready to pack it up and head home when the final client leaves. There is not enough energy left on either side to talk about or confront this day's major communication breakdown. Both doctors and the rest of the team end the day with a sense of muddled frustration. Even Dr. Greenskin, who usually enjoys grabbing problems by the horns and fixing this right now, is unsure how to approach the problem. Her usual resolve and tenacity has vanished, right along with her self-confidence.

We all experience moments of career frustration and doubt. Was this instance made particularly harmful by a lack of compassion or professionalism? Is anyone to blame specifically, and was there a failure to define expectations on either side? Is either side justified in the way they handled this day?

Dr. Codger may want to tread more carefully if he truly wants to retire and sell to Dr. Greenskin. And Dr. Greenskin may need to learn techniques to avoid becoming so totally frazzled.

Will these two find a way to resolve the day's conflict, or will it be added to the pile? How will the building tensions affect the outcome of the ongoing business dealings?

Dr. Jeremy Campfield works in emergency and critical care private practice in Southern California. He is also an avid kiteboarder.