Nice But Slow

We've all seen them. We all know who they are.

They all know who they are!

You see his name next to yours on the schedule, working alongside you, and you groan. Actually, sometimes you scream. Maybe you'll even try to switch your shift, using the excuse that you have to take your kids somewhere. Maybe you'll just happen to fall ill that day.

Yes, I'm talking about that wonderful emergency physician, the one who's been doing it for years. The one who sees patients at the whopping average rate of 1 per 90 minutes. Yet, he seems oblivious to the frustration he's causing. He smiles, apparently without reason, and is just so amazingly harmonious and agreeable to everyone. The secretaries like him. The nurses like him. Even his patients like him. Wouldn't you like your ER doc if he was able to pull a chair up and take the most detailed history you have ever had any physician take from you?

Those same ER docs are the ones who are fully aware that "they're going to have to kick me outta here, kicking and screaming, coz I aint leaving on my own." Yes you know who they are.

These doctors are the ones who inspire discussion about RVUs, and about productivity bonuses. These guys are often described as "well he's such a nice guy, but he's just so God awful slow". Whenever you work alongside him, the nurses repeatedly come up to you to see their critical patients, yet unassigned to a physician, even though you have 10 patients and he has 3.

Hell, the nurses will even come up to you for help with his patients!

So you either suck it up, or you do something about it. But what can you do? Can you complain to anyone? What can the medical director do? What can the nurses do? For that matter, what can the 'Nice But Slow' (NBS) doc do?

Occasionally, a petition from the nurses to the CEO may lead to a dismissal in such a scenario. But how likely is that, given he's just SO DAMNED NICE and actually quite a pleasant person to chat to. How can you possibly conspire to have someone fired who actually greets you with such a nice smile whenever you start your shift?

The medical director, I suppose, could tell the NBS doc to "speed up, or else". Or else what?

He's usually in his fifties, but he might even be in his thirties. There's no typical profile, except that he's always nice. The strange thing is, it's the fast docs who are not always so harmonious and pleasant. Maybe because they're so busy. Maybe because they get paid the same as the NBS doc but do 4 times as much work. Maybe because they consequently expose themselves to 4 times the medicolegal liability, and it's just getting old. Also, even though he's fast, there might be several nurses and other coworkers who would love to see him go. He makes them "work too hard" because he's constantly asking them to call physicians, put orders into the computer and get EKGs, orthostatics and blood sugars, at every opportunity. The coworkers just think he's a freaky stressed out guy, simply because he's carrying the workload. How interesting.

Mind you, there are some fast docs who are actually quite pleasant and all smiles. They have discovered the 'best of both worlds'. Be liked by your co-physicians as well as your other coworkers, as well as your patients. Is it such a tightrope? Is it such a big juggling act? Well, of course it is, but I do believe it's possible.

Providing quality, with quantity, as well as having a great spirit about, that is, being harmonious and agreeable and acting like you're enjoying your work, is actually possible.

So, getting back to Dr. NBS. What can we do about him? Short answer: nothing. Absolutely nothing. Let nature decide what happens to him. You just firmly plod along, doing your own thing, at YOUR own pace, no matter how fast or slow that may be, and do the very best for your patients. Don't be tempted to join in when people make comments about how slow Dr. NBS is being. Just let it slide and do your own work, and do it well.

That's all that matters.

So take it easy. Go to work. Smile. Enjoy yourself. Work like a Ferrari - fast and stunning, and nice to hang out with. Don't work like an old vintage classic, also nice to hang out with, but pretty darned slow. That's quaint, but practically useless in a modern emergency department.

As my Mom always says "You be good", and don't worry about the other guys.