I’m a first year doctor from Victoria, Australia.
This is my first year working in a team-based context, making decisions for patient management.
I’ve had a number of experiences this year with bosses whose management I disagree with. But I haven’t come up with a useful, constructive means to voice this disagreement.
Medicine is often a chaotic space to work, which doesn’t help, and your work satisfaction depends fundamentally on your relationships with your team.
Looking to hear any tips from others who have wrestled with this issue.
When you are voicing a disagreement it is hard to avoid choosing a party responsible for the disagreement. As an example of an extreme case one might say "you are wrong", placing all the responsibility on the other. It is hard to avoid placing responsibility, but it is easy to accept responsibility, so no pecking order is threatened, everyone is happy.<p>I'm not sure that I could give an example correctly, because English is not my native language, so I could fail to communicate subtle shades of meaning, but I try nevertheless.<p>"I see that you've chosen X as a decision, and I'm not sure why. I think, you've chosen X over Y, because of A, B and C, am I right?"<p>And I'd start small. Explicitly not challenging decisions of superiors. Asking questions afterwards, when it is certainly late to change decision (so no one tempted to think, that I'm trying to make it my way). Making sure that a person asked would see me as a newbie seeking wisdom: "I'm eager to agree with you, but I need to understand first". Choosing time when people asked do not need to stop doing some very important stuff to answer my questions. And so on. I'd poke the situation cautiously and watch what would happen. Hopefully I'd find people who are nice enough to allow me to ask them countless questions, to discuss decisions, and hopefully I'd find ways to ask questions which work without undesired social side-effects.
I try to construct scenarios using both sides. Usually, this changes the conversation to be about the desired outcome which one of us might have assumed incorrectly (or even just differently) when the problem arose.
As a long-time employer I've had my share of new graduates come into the business and tell me all the things we are doing wrong.<p>They are not wrong. And I'm happy to discuss it with them. But their "big picture" experience is limited, and this can matter.<p>I do not mean to patronise you at all when I say that the ideals of school sometimes have to bend when faced with limited resources. I know, I sound like every condescending oldster ever, but experience adds nuance that may be hard to see.<p>Obviously I can't speak to your situation, and I know nothing about medicine or medical teams [1] but there is one technique that may help you better understand the choices being made;<p>When advocating a specific approach pay lots of attention to the possible downsides of your recommendation. I've seen a significant maturation in my engineers when they can honestly articulate the down-sides of their point of view. If their answer is "there are no downsides" then it's easy to dismiss them as not fully understanding the problem. Every decision has a downside. But those who can see, and balance both the upsides and the downsides, who understand the negative impact of their choices, are starting to show their maturation.<p>In most cases there is no perfect approach, and ultimately someone has to make as decision, which may turn out to be right or wrong. And I get that in the medical field the impact of being right or wrong is significant. I don't envy you that.<p>[1] anecdotally I try not to work with doctors. The nature of your job requires that you project high levels of confidence with minimal data. Given the placebo effect I understand this - no-one wants an indecisive doctor. Alas this character trait works less well when interacting with other professions about _their_ area of competence. I've found doctors difficult to program for because (with respect) their ego gets in the way. When everyone treats your word as gospel, and you must "never be wrong", it's easy to become self-important. I don't tell a plumber what kind of pipes to use, but doctors all try and design UI with unfortunate workability issues.<p>In any team there are going be different opinions, and in the heat of battle there isn't time to pass on all the data that matters. But in the aftermath I encourage you to speak to your team leader about the decisions he took and try and learn from the experience. Sometimes she will be right, sometimes your approach may have been better. No-one is right all the time.<p>And in 10 years remember this process when you are team leader and some fresh-of-school youngster tells you the "obvious best thing". Be open to learn from them, but also forgive them their absolutism.<p>Above all, thank you for your service in this most trying of times. You have entered a meaningful profession at a opportune time.