Speaking up—when doctors navigate medical hierarchy

Ranjana Srivastava
New England Journal of Medicine 2013 January 24, 368 (4): 302-5
He's the first patient of the day: admitted overnight, he's scheduled for surgery this morning. "Do you want to catch him before or after?" the resident asks. "Is there anything we need to do for him right away?" I say. When she says that the night resident mentioned some pain issues, I decide to..

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Ann La

This is one of the best articles that I have read in a long time. All physicians especially those in training should read it and learn the importance of communicating out thoughts and being open to other's suggestions.


Inessa Yurtsev

A great article for young doctors and nurses.


PN Draper

Thank you for writing about some of the many "untaught" things in medicine. As an anesthesiologist, I was disappointed in the lack of commentary from the attending anesthesiologist in this case, so I am left to believe their thoughts were not solicited, which I would have been interested in reading. Secondly, as you point out, there is this certain deference the medical profession has towards surgeons (and other specialties), which needs to be challenged, all for the sake of the patient. As I always tell the resident trainees, you will always find a surgeon to cut, and an anesthesiologist to give an anesthetic-just because we (in medicine) CAN do something, doesn't mean we SHOULD. In the end, professional respect (of others opinions) and communication (between all health care providers) usually leads to "doing the right thing".


Asma Shihabeddin

Good article with a bibliographical taste. I'm always puzzled by the medical hierarchical system and the minuses it has and how we change it. Your words told me that I' m not alone. Unfortunately expressing your concerns to a colleague usually stir discomfort, suspiciousness and even anger. Some bear grudges!! If we are really loyal to Ethics, we have to encourage challenging various viewpoints and effective scientific communication.


gabriele gallone

A great article. Simple, straightforward. Every doctor should read it


Apostolos Nakas

The article makes a few food points


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Trived Soni

A good read. One that realises teamwork in reaching the ultimate goal that is giving the best for patients.


Denise Nelson

How is the new healthwatch likely to contribute to local health care


Pagal Premi

My ches pen


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