How medicine can breed arrogance

During my residency, I encountered a stunning example of how medicine can breed arrogance.

While working my ICU rotation, a patient's family asked me to make the tough decision to withdraw care. I told the senior resident that we were going to take the patient off life support, and the family would be in the room.

The senior resident ordered medications to ease the patient’s pain. But when the nurse wanted to order a higher dose of morphine so the family wouldn’t have to witness any labored breathing when she removed the breathing tube, the senior resident refused, saying he was the doctor and knew the correct dose.

The nurse paged the attending on call and got sufficient morphine to make the patient as comfortable as possible during their last moments of life.

When pride turns to arrogance

Working with fellow doctors who have poor communication skills, are arrogant, and always have to be in control not only makes things difficult for patients but can also breed a hostile work environment.

We will never know everything, partly because there is just too much to know and partly because medicine is an evolving field. It’s a breath of fresh air to learn constantly, but this learning environment can breed competitiveness and drive egos.

We spend decades in school and training, make endless sacrifices in our personal lives, and go into hundreds of thousands of dollars in debt to go into medicine and care for patients. It’s only natural to take pride in what we do.

Pride is a healthy trait. We should all take pride in our achievements and skills. However, too much of it can turn into arrogance, which can quickly cause difficulties in a practice’s workflow. Arrogant physicians have a difficult time admitting mistakes. They may think they know better than their colleagues.^[]

Working with a "know-it-all" colleague can be draining, lead to a toxic workplace, and potentially compromise patient outcomes, as the arrogant physician will often compromise integrity to maintain their inflated self-image.

Sense of self-awareness

This means seeking honest feedback and constructive criticism about your strengths and weaknesses from co-workers including nurses, senior doctors, medical students, and residents.

Talk with co-workers about their experiences with pride and arrogance and how they deal with making mistakes. Be honest with your knowledge and experience. Prioritize integrity and patient safety over self-image.

Learning how to say ‘I don't know’

One of the most difficult things to learn as a medical student and young physician is how to be comfortable with the phrase "I don't know." Medicine in a punitive culture where we’re supposed to know all the answers, even though this is very unrealistic.

Some highly respected physicians are not ashamed when they don't know the answer, make a mistake, or ask a colleague for help.

We are called to do more than diagnose and treat the body. Sometimes it doesn’t matter how smart we are, where we trained, or how many years of fellowship we went through. Sometimes, we need to put our pride aside so we can step into the role of a healer.

When we can no longer heal the physical body, we can humbly help heal the broken hearts of family members as they watch their loved ones take their last breath. Our treatment plans and knowledge do not matter in these times; what matters is if we can comfort them. When our pride turns to arrogance, we fail our patients.