The Resident's Scolding

Dr. Dev (Fictional Name) went to meet his friend Dr. Jolting (Fictional Name) at his hospital. Dr. Jolting was taking the ward round at that time. When he saw the case sheet record of one patient he first frowned and then angrily scolded the junior resident doctor in-charge of that patient, ‘Why is the case sheet not complete?’

The patient was suffering from an infected wound on his leg. It had happened that the junior resident had done debridement i.e. surgical removal of the infected tissue, and dressing of the wound the previous day but had not written it down in the case sheet. So, even when the surgery had been done, the case sheet showed that the patient was just being treated with antibiotics and pain killers.

After Dr. Jolting reprimanded the resident for not maintaining the proper record, Dr. Dev noticed a strange thing. 

With a softening of his voice, Dr. Jolting suddenly changed his tune. He said to the resident, ‘You are such a hard-working person and take such good care of the patients. But all your hard work does not get reflected in your written record. Next time write down in the case sheet all the hard work you are doing for this patient!’

Once the ward round was over and Dr. Dev was alone with Dr. Jolting in his chamber/office, a curios Dr. Dev asked Dr. Jolting to explain his strange behavior of first scolding and then praising the resident within few seconds.

Dr. Jolting explained, ‘First I scolded the resident as negative conditioning, that he remembers in future that if his work is not up to the mark then he will be disciplined.’ 

‘I then praised the resident, as he had actually done the work as positive reinforcement. Also, the patient and his relatives were watching closely the entire time. If I stopped at the scolding stage then the patient and his relatives would have carried the impression that the patient is not receiving proper care in the hospital. You may think it is the resident who will be blamed, but the good name of the entire hospital will be besmirched along with me as his supervisor. They will say that the doctors of this hospital are not taking proper care of the patient. There will be collective infamy.’

Dr. Jolting continued, ‘By praising the resident for the work he had actually done in front of the patient and relatives, there is first positive conditioning, that the resident remembers that if he will do good work it will get appreciated. Then again by praising in front the patient, the reputation of the hospital gets a build-up and the patient understands that the resident had just done a clerical slip up and not done any actual error or mistake in the patient's care. This will help in preventing any litigation or charges of deficiency in the patient's care from him in the future.’

If your junior staff had done some error, avoiding bringing the matter in front of your patients/clients/customers. This will damage the reputation of the entire hospital/institution/organization.

If someone had done good work along with some error then be balanced in your feedback with praise for the good work and chastisement for the error. While penalizing for the error or deficiency do not overlook any good part of the work done by them. You will then earn the reputation of being a fair person who gives what the juniors actually deserve.

 (Based on an allegedly true incident)

— ND

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DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use of the information herein is at you one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Practice should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost. 

DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use of the information herein is at you one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Education should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost and according to MCI and other Board’s norm