The Grumpy Doctors Are The Ones We Should Learn From

Why You Should Spend Time With Caustic Professionals

Key Takeaway:

The grumpy doctors are the ones you should learn from because they do not “look the part” of a physician. Assuming they are equally reputed as the nice doctors, they must have some skill that makes them over-compensate for the caustic demeanor. Hence, you may learn more from them with that skill with the following assumptions:

o   They pay the consequences for being bad at their job

o   The skill they are super good at is something you want to learn

o   They are not against teaching you

When I am in the clinic, I'm always a little nervous. I would always receive similar reassurance from the surrounding staff, probably because they could sense how nervous I was. "Don't worry. She's a very nice doctor." In a sense, we assume that the nice doctors are the ones we want and should learn from. But is this the case?

I think it's the grumpy doctors we should learn from.

In Nassim Taleb's book Skin In The Game, he discusses how one can assess the competence of an expert by saying, "…but, conditional on having had some success despite not looking the part, it is potent, even crucial information" (156). If you choose between two equally reputable surgeons—one that is handsome and comes from a prestigious medical school and another that looks like butcher and hides where he went to school out of embarrassment, you should pick the butcher. Conditional that both are equally reputable, the butcher is likely to be overcompensating with more skill than the surgeon who better looks the part.

I think something similar applies to grumpy doctors as well. The ones who are too caustic, disagreeable, and irritable for team-based clinical environments might have skills that keep them a valuable part of the team despite not "looking the part" of a physician. Perhaps they are outstanding in complex clinical decision-making despite chewing out their residents. Maybe they stay so up-to-date on the literature even though they came from a Caribbean medical school.

The Exceptions To This Rule

No Skin In The Game Filter

This heuristic would most apply in environments where "Skin In The Game" [SITG] is present. In other words, an environment with SITG is where poor players in a game suffer the negative consequences of their actions. A morbid example of this is forcing civil engineers to live under the bridges they build for a city. My heuristic rests on the assumption that the system that deems people reputable is reliable because it would remove people who did not hit particular standards. In many environments, this may not be the case. Prominent examples include certain academic or administrative positions.  

Irrelevant Over Compensatory Skill

The heuristic may also be unhelpful if the over compensatory skill is not something you deem worthwhile. Consider the physician who's a bit caustic—to put it lightly—yet they remain an integral part of the private practice because they know how to siphon patients into money-making procedures. While impressive from a business perspective, you might find this unethical and wish not to learn it. [Though one could argue that this might be good to observe so you know what social policy to advocate for to prevent physicians from doing this in the future  Make footnote]

No Interest in Teaching

Sometimes the grumpy physicians have no interest in teaching you anything. They would rather do their own thing and you would just get in the way. In this case, it may be difficult to learn much. In my experience, however, if someone is really good at what they do, there’s a certain kind of pleasure derived from teaching people about the craft they are a master in. They will most likely want to teach you something. They just might not be nice about it or do so directly.

You should learn from physicians who are incredibly competent and kind, compassionate, and a pleasure to work with. Yet, there are times when it's with imperfect people that we can learn most.