Don’t Question the Doctor Part 2

I posted last week about my friend Lois’ run in with a nasty doctor soon after she graduated nursing school in the 60s.

Here is my story about working with a difficult physician that took place in the mid 80s.

The medical director, Doctor X, sat me down in her office on my first day as a nurse practitioner in a home care program at a large VA Medical Center and said, “When the doctor and nurse disagree, the doctor WINS.” She repeated this twice with a glare to discourage whatever protest I might be considering.

I can still see her fleshy face framed by cropped curly hair and a white lab coat stretching over her heavy shoulders. We sat in two chairs in her warm office facing each other without a desk between us. Did she know something about me that prompted this confrontation? Or was she always so caustic with nurse practitioners? She was a rising star in the organization. I didn’t expect this intimidating behavior.

I nodded my head as if I agreed with her dictum. What good would it do to argue since I hadn’t a clue what kind of disagreement we would have? What could happen in a health care setting that would be black or white, right or wrong, a doctor wins and a nurse loses?

What reassured me that Dr. X and I might never have a run in was that I would have autonomy when I made home visits. And I would call another doctor on the team if I needed advice, not the medical director.

One day, while visiting a patient his wife stated, casually, that Dr. X had stopped by on her way home from work. She felt flattered that the medical director would take the time to see how she and her husband were doing. What reason did Dr. X have to visit and not tell me? Not wanting to involve the patient’s wife in a conspiratorial alliance, I smiled and said nothing.

Dr. X visited a second patient. The scenario was the same: wife mentions the visit, I smile and say nothing. An uncomfortable sense of being under surveillance hounded me. What was Dr. X looking for?

Shortly after, Dr. X was promoted to a leadership position and left the home care program. There was no fallout from her clandestine visits to my patients. Would there have been if she stayed with the home care program and continued her unorthodox conduct?

I am grateful that I didn’t need to confront her—for surely I would lose.