Feeling undermined - advice please!

[feelinginthedark]

I'm a doctor and work in a large multidisciplinary team. I did some of my training in the organisation that I'm working in, and now am back here working as a consultant. My issue is with my, former, boss and trainer; now, colleague. My issue is that she consistently questions my clinical and management decisions in front of more junior members of the team. Essentially she acts as though I'm a registrar and she is 'training' me. She is more experienced than me and is the medical director of one of the organisations we both work in (small helathcare service), but I don't report to her in this setting.

We work particularly closely in a different setting (large acute hospital), and she is not in any way my boss in this setting. We work as part of the same team in this setting, but we essentially manage our own caseloads. She has recently started not only questioning my clinical judgement, but 'butting in' on my patients, taking over, and becoming involved in their care. She sees it as 'helping' while I see it as a further eroding of my position in leadership as perceived by the junior doctors and our specialist nurses. A bit lost in terms of how to deal with this and would appreciate any advice / wise words....TIA

If you believe her actions are detrimental to the care of the patients who are allocated to your care i.e. She contradicts your decisions and changes the care you are putting in place, then yes you definitely need to escalate this.

I would give specific examples to her directly about the detrimental effects she is having on your ability to do your job.

Make sure it's all about the patients. See if it has the desired effect of highlighting the problem. Maybe she thinks she is helping by imparting "wisdom" but it must be very frustrating all the same.

I once told my boss' boss "when you did X I felt undermined". She had taken the piss out of me at the start of a meeting that I was chairing that involved her, her boss, and two other people three levels up from me. I did not tell her at the time, I cracked on with the meeting, but I was shaken up and gave her the feedback later.

She and I work well with the direct approach and I am articulate with my emotions.

It did help. Sometimes other people are oblivious to the effect that their behavior is having on others.

One thing that is helpful is to uncouple their behaviour and your emotions. So instead of "you undermined me" or, worse, "you're making me feel undermined" just "you did X and I felt undermined". The latter is more factual. The first implies motive in the person who did it and the second infers causality which is only partially there - the other piece of the feeling undermined is your piece.

I do appreciate that clinicians having emotions is not particularly kosher. I'm not that kind of doctor and think that that kind of tosh is bollocks myself.

Can you find a mentor to help you to navigate this situation?

She is more experienced than you. You don't yet know everything she knows. Both of you still don't know everything there is to know and both should acknowledge that you are always open to learning something new. Focusing on your right to not have your judgement questioned is a bit petty tbh. If your judgement is sound then it is no bad thing for it to withstand questioning. Either your decisions are correct and you can defend and stand by them or they are dodgy and patients will suffer. I expect that the former is more likely as I am sure you have worked very hard to get where you are. However, a culture where doctors do not question each other out of professional respect is one where weaker decisions are allowed to pass unquestioned. As a patient I would rather you welcomed your colleague's questioning and used it as a bona-fide test of strength. entertain the possibility that she may be right, or maybe she is wrong, but if you don't even get told what she thinks then neither of you will learn anything new.

I disagree that it is petty. One option would be to clarify who has clinical responsibility for the patient in question and who has responsibility for which aspects of whose care. How far does she go? Does she interact with the patient directly? Prescribe stuff without your agreement? Make referrals? Any of these could be detrimental to patient care.

both should acknowledge that you are always open to learning something new

There are lots of things that should be and are not. OP cannot control what her colleague does or does not acknowledge. Some people are not open to learning new things.

I think there is a difference between someone with experience giving an alternative perspective, which is helpful, and the person wading in with their elbows out, giving their two'pence worth with no regard for the clinical standing of the HCP who is meant to be making recommendations about patient therapy, which is not helpful.

The key question is, is the person chipping in on an 'ego trip' or so they genuinely feel the need to give information stick their nose in so the patient benefits....

I like your emotional intelligence in how to resolve the matter, erinaceus .

Thank you daisychain01. I feel flattered. I remember you from my thread in Employment Issues. Thanks for your help on that one.

Glad to have helped you erinaceus