Physician Leadership During COVID-19. Team, Gratitude, Patience and Grace.

Guest Blog by Dr. Rachel Mednick Thompson, Pediatric Orthopaedic Surgeon

As an orthopaedic surgeon, I am currently not on the frontlines, fighting against the enemy that is COVID-19, as many of my colleagues are. I cannot imagine the stress faced by doctors leading the teams in the ED and the ICU, but I know that each of them will be pushed to their personal limits of patience and grace. Physician leadership has never been more important.

(See our recent guest blog by Bob Carr, MD, MHA – Finding Purpose and Growth in the COVID-19 Crisis )

But I can remind my colleagues that in times of stress, it’s even more important to make your teams know that they are valued and to express gratitude.  My own recent experience served as a reminder of the influence physicians have over their teams, what their team members need to function at their highest level, and what it takes to instill a sense of pride in their work – even in the best of times.

The Case

At the beginning of March, COVID-19 was a distant problem.  My surgical schedule was at full capacity, and I was operating on the child of high-profile parents. The surgery had been scheduled for months; I was well-prepared for the case and confident in my ability to make this child “better,” but there was a palpable nervous energy in the pre-operative area as I went to sign the operative limb. This energy followed me into the OR. I could feel the pressure of getting this case “right.” 

As a pediatric orthopaedic surgeon, I am acutely aware of the privilege of being entrusted to care for someone’s child, regardless of who that someone is. I constantly remind my trainees of this privilege and the associated responsibility therein. I don’t aim to treat each child as if he or she were my own. Rather, I remind myself that a mom, dad or caregiver entrusted me with her child. I take this responsibility seriously, and I feel the gravity of this responsibility with each surgery. Add to this the pressure of operating on this particular parents’ child, and I was on high alert.  

My Own Tension Set the Tone

The case started well, but I could hear myself becoming short with my nursing staff, and I could sense how easily frustrated I was becoming if something wasn’t perfect. I was unpleasant. I was graceless. Despite the fact that the x-rays were perfect, and the patient did well throughout the case, as I walked out of the OR to discuss the case with the patient’s parents, I felt defeated. I was embarrassed by my behavior, and I did not want to be the surgeon that I had been for the past 3 hours. 

“I was embarrassed by my behavior, and I did not want to be the surgeon that I had been for the past 3 hours.”

Thanking My Team for Their Work and Patience

I had two fairly large surgeries the next day. When I walked into OR 1, my team was as kind as always, letting yesterday’s behavior go unmentioned. Having worked with the same team since I started my career allows me the benefit of the doubt, and I could have also ignored my regressive behavior and poor attitude. But I didn’t want to let myself off the hook. Instead, I rounded up everyone that had helped me the day before and everyone that was going to help me that day, and I asked them to each write down their order from a local café, and we ordered a team lunch.

(COVID 19 – Leadership and Teamwork Were Never More Important – Supporting Our Clients)

It was too small a gesture to thank this team for all of their work and patience, but in the bustle of the OR, a heartfelt, sit-down thank you is unlikely, and I wanted everyone on my team to know that I see their work, appreciate their time and understand that their contributions are as important as my own.

And with this small action, my team became closer, we worked even harder and with a levity that made the work more enjoyable and fulfilling. At the end of that day, the outcomes were similarly as good as the day before, but I walked out of the hospital with a smile on my face.

“And with this small action, my team became closer, we worked even harder…”

As my colleagues face this crisis, I know you will be overwhelmed with the workload, the demands, and the stress.  I would encourage you to find ways, no matter how small, to express gratitude for your teammates.  It will serve to center them and allow them to walk away from each harrowing day with the sense of pride and accomplishment that is deserving of the vital work that they are performing.

Rachel Mednick Thompson, MD, is Assistant Professor-in-Residence of Orthopaedic Surgery, Associate Residency Program Director, Department of Orthopaedic Surgery, and Associate Director, the Center for Cerebral Palsy at the David Geffen School of Medicine at UCLA, Orthopeadic Institute for Children.