The “collegial relationship” – in medicine and in business

The “once this year” section was updated 11/5 for better wording.

Of all the statements I’ve heard in medicine, in hours and hours of speeches and talk, none has stopped me in my tracks more than this:

“If you have a collegial relationship, you can talk about it.”

The event was a conference at Maine Health, 5/17/12, and the speaker was Richard Rockefeller, MD. I’d given a talk that morning, and he was part of a later panel.

His name stuck in my mind because he was one of the “White Paper Advisors” cited by e-patient founder “Doc Tom” Ferguson. I knew that Rockefeller was no longer practicing, so it was a special treat to get to meet him.

The statement arose during Q&A. A physician in the audience asked a very common question:

“I understand that patients today can contribute valuable information. But what do you do when they bring in something that really is garbage?

Richard thought for a moment, and said:

“If you have a collegial relationship, you can talk about it.”

Perfect. “Collegial” means you’re colleagues – I googled “define:collegial” and got these, among others:

“relating to or involving shared responsibility, as among a group of colleagues.” (Oxford)

“marked by power or authority vested equally in each of a number of colleagues” (Merriam-Webster)

“Colleagues are those explicitly united in a common purpose and respecting each other’s abilities to work toward that purpose.” (Wikipedia’s entry on “Collegiality.”)

Shared power & authority, common purpose and respect. Doesn’t that sound insipring?

Rockefeller’s response struck me for three reasons:

• Superbly and concisely, it  summarized everything I feel about participatory medicine and patient engagement.

• It’s so different from the usual response to this question,
  which is to argue about the validity of the information. To Dr. Rockefeller, the useful thing to look at is the relationship.
  • When HealthLeaders magazine introduced our Society for Participatory Medicine in September 2009, they put it on the cover (above), and explicitly cite “a new relationship” – right on the cover. That’s what they call front page news.

• In a different context, “collegial” matches exactly what I need, as a small growing business, in my relationship with clients. Trust, respect, shared purpose.

In medicine, my clinicians are my partners. We are united in a common purpose and respecting each other’s abilities.

Similarly, in business the people I speak to by email or phone are my partners. We work together to define a common goal; we agree on terms, we agree on the work; we coordinate to make sure everything goes as planned. And when anything goes wrong, “you can talk about it,” as Rockefeller says.

In medicine, if a clinician is rude or even insulting, I get a divorce: we are there for my health, not his or her ego. If I say something dumb, I expect to be taught. (S/he’s my chosen expert, right??)

In business, in the rare cases where a partner has accused me of not acting in good faith, the relationship has similarly ended. Once this year, after months of planning a complex engagement, I asked for specifics of what I’d be doing and asked for the promised contract. The response surprised me: I was accused of micromanaging and not trusting, and I was told that wasn’t acceptable.

Note: no sense of shared anything: “We’ll organize everything, you’ll do as you’re told, and no you don’t need a contract.” Not how colleagues treat each other.

Well! That engagement ended for other reasons, but there’s no chance I’ll do business with them. And in contrast, this fall I have a complex multinational engagement, and we’re all working together great.

Since that day in Maine I’ve realized “collegial relationships” are what I live for. I hope this post will help you, too, think about what inspires you in your work with others – and think collegially, as is the norm for almost everyone I know!
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p.s. This thinking may be unfamiliar but it’s not new. Ferguson’s White Paper quoted Rockefeller in chapter 2, which includes Seven Preliminary Conclusions, in #6, titled, aptly, “Clinicians can no longer go it alone.” The Rockefeller paper he cited was from 1999. Not new – not at all new. But one of Ferguson’s favorite quotes was from futurist William Gibson: “The future has already arrived. It just isn’t evenly distributed yet.”