Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

What medicine can learn from the fire department about team-based care

Pooja Desai
Education
October 11, 2016
Share
Tweet
Share

Through a thoughtful, community-based education program at my medical school, I spent a week rotating with my local fire department. Immediately, I was immersed in the first-responder field. I learned how to set up a transcutaneous pacemaker, properly unfold a fire hose, and plan ground strategy for wildfires. But what I will remember most years from now is something much less technical: the incredible value of team camaraderie.

More than once, firemen came up to me and said, “Isn’t this the best job ever?” Another one told me,“There’s nothing else in the world I would rather do.” When I asked why, I was surprised that the most common response was not related to the nature of the work, but that it was “each other.” This is when I started to pay attention to their vigorous camaraderie.

Teamwork is sewn into the fabric of the fire department. Each firefighter and paramedic has clearly delineated responsibilities; they work efficiently, communicate well, and interface with other organizations (ambulance, police, trauma doctors, etc.) with little tension. Best of all, they have a great time doing it. After calls, they would tell each other “good job” or “great work.” There was an abundance of compliments and positive reinforcement. Outside of calls, they worked out, cooked, and joked together. For a week, I was part of this team. I started to understand the love they all had for each other, because I felt it, too. After each response, I felt the rush of accomplishing something together, and I was aware that our mutual respect had been integral to every accomplishment. After that week, I was sad to leave.

This camaraderie stands in stark contrast to what I have thus far observed in medicine.  In medicine, the work is efficient, but there is not much positive reinforcement. Patients are roomed, interviewed, treated, and discharged, but there is no spirit infused into these processes.

Further, hierarchy is ever-present in medicine whereas in firefighting, it is only in the background. Each firefighter has individual responsibilities that require different training, just like doctors and nurses do, but one role is not made to be better than another. They are simply different, important components. This equality extends socially, too. The captains and chiefs ate dinner with us, did the dishes alongside everybody else, and put in an effort to be part of the community. Meanwhile, on my clerkships, I have seen groups of nurses organize after-work socials together, and I have seen doctors mingle with each other, but I have almost never seen those two groups, or any others, do so together.

For being so different in work culture, these two fields are actually very similar. Medicine operates in life-or-death stakes and utilizes a broad, interdisciplinary care system just like firefighting does. So why do these differences exist? I considered possible reasons:

Is the medical field too competitive to allow for interprofessional empathy? However, first-responders are also internally competitive. In Southern California, for example, there is a major surplus of individuals trained in these fields compared to the number of jobs and promotions.

Parts of medicine are dry and slow-moving. Is there some innate group euphoria that comes from responding to emergencies for first responders that cannot be generated when treating chronic illness? However, the collegiality was a part of nearly every aspect of the firefighters’ daily activities, not just the exciting ones (even paperwork!).

Much of medicine is profit-driven. In contrast, the fire department is a completely public organization. Physicians have to work under external financial pressures from hospital administrators, pharmaceutical companies, and insurers that may influence their behavior, but that do not plague first-responders.

The critical difference might lie in sheer workload. In the fire department, there was downtime to eat, talk, laugh, and rest between emergencies. In medicine, there is no such thing. The demands of patient visits, documentation, responding to consults, and taking calls are unrelenting, and perhaps prohibitive of a happy workplace.

Regardless of the reasons, team-based care is not a foreign term in medicine. It was discussed during my medical school interviews, preclinical curriculum, and clerkships. But until I contrasted the spiritless, practical teamwork of medicine to the lively camaraderie of the fire department, I never truly understood the extraordinary potential of team-based care to improve not just patient outcomes, but also provider satisfaction and happiness. There is a sense, I think, that in medicine there is no time to create a positive work culture, and no necessity for one. But what I experienced in that week of firefighting was enough to convince me that camaraderie does not have to be out of the question for medicine if we make simple, intentional changes.

Physicians and physicians-in-training are in a unique position to improve this. The attending physician is described as being the “director” of each health care team. But by assuming the skills necessary for this role are merely clinical, we are underestimating what this role requires. He or she is responsible for setting the standard for the team dynamic; active positive reinforcement, respect, and inclusion to all team members is vital. Trainees should be involved in this transformation, too. We spend hours of medical school practicing the art of the patient interview, learning how to cultivate rapport and trust with patients. We should be placing similar emphasis on honing inter-team communication during our training.

The insight I gained is just a fraction of what medicine could stand to learn from other professions, and similar interprofessional education should be promoted across all medical schools. Of recent, our profession has been shaken by the recent suicides of students, residents, and physicians across the country, calling greater attention to the academic stress and competitive environment of medicine. Rather than assume that the culture we perpetuate is status quo, let us be open-minded enough to see its flaws and empowered enough to fix it.

ADVERTISEMENT

Pooja Desai is a medical student.

Image credit: Shutterstock.com

Prev

Watch this inspiring journey of an orthopedic resident

October 11, 2016 Kevin 0
…
Next

Patient satisfaction can be done right. Here's how.

October 11, 2016 Kevin 23
…

Tagged as: Medical school

Post navigation

< Previous Post
Watch this inspiring journey of an orthopedic resident
Next Post >
Patient satisfaction can be done right. Here's how.

ADVERTISEMENT

Related Posts

  • Primary Care First: CMS develops a value-based primary care program for independent practices

    Robert Colton, MD
  • What medicine can learn from a poem

    Thomas L. Amburn
  • The expanding role of specialists in value-based care

    Martin Lustick, MD
  • Solving the problem of non-emergent care in the emergency department

    Michael Kirsch, MD
  • Behavioral health providers face challenges in value-based care

    Martin Lustick, MD
  • Considering the recent setbacks of evidence-based medicine

    Kenneth Lin, MD

More in Education

  • Imagining a career path beyond medicine and its impact

    Hunter Delmoe
  • What is professional identity formation in medicine?

    Adrian Reynolds, PhD
  • How Filipino cultural values shape silence around mental health

    Victor Fu and Charmaigne Lopez
  • Why leadership training in medicine needs to start with self-awareness

    Amelie Oshikoya, MD, MHA
  • Learning medicine in the age of AI: Why future doctors need digital fluency

    Kelly D. França
  • Why health care must adopt a harm reduction model

    Dylan Angle
  • Most Popular

  • Past Week

    • Why palliative care is more than just end-of-life support

      Dr. Vishal Parackal | Conditions
    • When life makes you depend on Depends

      Francisco M. Torres, MD | Physician
    • Guilty until proven innocent? My experience with a state medical board.

      Jeffrey Hatef, Jr., MD | Physician
    • Why medical notes have become billing scripts instead of patient stories

      Sriman Swarup, MD, MBA | Tech
    • How denial of hypertension endangers lives and what doctors can do

      Dr. Aminat O. Akintola | Conditions
    • A powerful story of addiction, strength, and redemption

      Ryan McCarthy, MD | Physician
  • Past 6 Months

    • Why transgender health care needs urgent reform and inclusive practices

      Angela Rodriguez, MD | Conditions
    • COVID-19 was real: a doctor’s frontline account

      Randall S. Fong, MD | Conditions
    • Why primary care doctors are drowning in debt despite saving lives

      John Wei, MD | Physician
    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • Confessions of a lipidologist in recovery: the infection we’ve ignored for 40 years

      Larry Kaskel, MD | Conditions
    • mRNA post vaccination syndrome: Is it real?

      Harry Oken, MD | Conditions
  • Recent Posts

    • Imagining a career path beyond medicine and its impact

      Hunter Delmoe | Education
    • What is professional identity formation in medicine?

      Adrian Reynolds, PhD | Education
    • A step‑by‑step guide to crafting meaningful research questions

      Julian Gendreau, MD | Physician
    • When recurrent UTIs might actually be bladder cancer

      Fara Bellows, MD | Conditions
    • How restrictive opioid policies worsen the crisis

      Kayvan Haddadan, MD | Physician
    • Why doctors should rethink investing compared to the average U.S. investor [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 7 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Why palliative care is more than just end-of-life support

      Dr. Vishal Parackal | Conditions
    • When life makes you depend on Depends

      Francisco M. Torres, MD | Physician
    • Guilty until proven innocent? My experience with a state medical board.

      Jeffrey Hatef, Jr., MD | Physician
    • Why medical notes have become billing scripts instead of patient stories

      Sriman Swarup, MD, MBA | Tech
    • How denial of hypertension endangers lives and what doctors can do

      Dr. Aminat O. Akintola | Conditions
    • A powerful story of addiction, strength, and redemption

      Ryan McCarthy, MD | Physician
  • Past 6 Months

    • Why transgender health care needs urgent reform and inclusive practices

      Angela Rodriguez, MD | Conditions
    • COVID-19 was real: a doctor’s frontline account

      Randall S. Fong, MD | Conditions
    • Why primary care doctors are drowning in debt despite saving lives

      John Wei, MD | Physician
    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • Confessions of a lipidologist in recovery: the infection we’ve ignored for 40 years

      Larry Kaskel, MD | Conditions
    • mRNA post vaccination syndrome: Is it real?

      Harry Oken, MD | Conditions
  • Recent Posts

    • Imagining a career path beyond medicine and its impact

      Hunter Delmoe | Education
    • What is professional identity formation in medicine?

      Adrian Reynolds, PhD | Education
    • A step‑by‑step guide to crafting meaningful research questions

      Julian Gendreau, MD | Physician
    • When recurrent UTIs might actually be bladder cancer

      Fara Bellows, MD | Conditions
    • How restrictive opioid policies worsen the crisis

      Kayvan Haddadan, MD | Physician
    • Why doctors should rethink investing compared to the average U.S. investor [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

What medicine can learn from the fire department about team-based care
7 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...