I stood in line behind a physician, slightly balding and in a long, starched lab coat at the coffee shop in our hospital. As he paid and took his coffee, I noticed that he smiled and called the clerk by name, “Thank you, Terri.” He went on about his day, and I was left to wonder about the man, his practice and what type of person he was.

My friend has a son who is graduating from a prestigious orthopedic training program. He is about to begin his job search and the question comes up, “How do you know a good (integrity-filled) practice?” This young man recognizes that it is not all about the money and that true success in life comes from fulfilling work, good co-worker relationships and being honest with one another.

Being a nurse married to a physician, and working in the medical field, I have a front-seat opportunity to observe the benefits of great partnerships in medicine, as well as some of the difficulties of a mismatch in care styles and practice philosophies. All professionals know that finding a good fit at work is one of the keys to long-term professional success, but how do you decide if it is a “good” practice or not? And I can tell you, especially if you are a newer practitioner, about to get “out there” in the world of medicine, that there is truly nothing but pain, sadness and brokenness on the wrong side of the fence of integrity. The short term gains may be tempting, but wearing a doctor’s coat that is sullied by compromise is demeaning and in the end, takes you farther down a dark road than you ever thought about going.

No one goes through medical school and training thinking that they will ever compromise their standards, but instead, they might think, “I will have an awesome, financially rewarding practice and still provide the best care around.” That goal is lofty and attainable but requires a daily dedication to goals that put others first, that require self-sacrifice and the ability to commit to long-term plans.

So, back to the question at hand: how do you know whether a practice is “good” or not? Here are some ideas to consider:

1. How do they treat others? Follow the prospective partner around for an hour or two. It doesn’t take all day, but it requires that you step away from a recruiting table, from a computer and spend some time going room to room in the office or in the hospital or in the OR, seeing how this person acts in relationship to others. Ask yourself some questions: does he/she show respect to all others, regardless of their educational preparation, race, nationality? Do they treat the janitor, the surgical tech, the nurses with the same acknowledgment of a job well done? Do they seem to at least have a good working relationship with their peers? Admittedly, everyone is not going to get along with everyone else, we all get that, but a general attitude of respect speaks volumes about long-term success.

2. Do they routinely engage in continuing education and give it actual time in their schedules instead of lip service? Do they seek to amplify and perfect their medical skills and listen when new evidence-based medical research is published and alter their practice habits? This is especially important to note in the older, more established practitioner because we all know that as time goes on, our tendency is to become more entrenched, less flexible. A lack of dedication to continuing education, to adopting new knowledge, can result in a practitioner that loses touch over the years of practice — staying with the “tried and true” and not being willing/able to let go of the overconfidence that speaks the arrogant deception into their soul, “You’ve got this.” The byproduct of listening to that subtle self-lie is a physician who gradually becomes focused on the monetary rewards, the position, the power and begins to treat those around themselves as less than. The arrogance of knowing it all, having the best technique, being so accomplished that there is nothing left to learn, completely undermines best practice techniques and leads to an erosion of integrity that is impossible to shore up later.

3. The practitioner with integrity is concerned about — and lives out — having the patient’s best interest at heart. On some level, the physician with integrity is expressing, and more importantly, putting into the practice, principles that show that they have their patients’ long-term best interest in mind. Whether it is sacrificing some short-term gain in order to hire ancillary personnel that help address patient’s day-to-day needs and concerns or whether it is taking the time to discuss weight loss instead of surgery or exercise/therapy instead of interventional care, all of these approaches can show dedication to ultimate good for the patient instead of a focus on short-term gains. A practice that shows an emphasis on meeting the patient’s needs rather than solely the physicians’ will probably require more work, more selflessness on the part of the partners, but it is also a situation that tends to produce more and more lasting job satisfaction. Yes, hiring an additional receptionist to actually answer the phone and address patient needs is expensive, but when we shortcut these investments in good practice in order to broaden the bottom line, we do ourselves, and certainly the patients, a disservice.

4. Are they a team player? Do they give others’ credit? Do they refer well and network well? Medicine is no longer a solo practitioner affair. It takes all the players on the team working together to equal great care.

5. Trust your gut on this one. Life is full of choices, and sometimes we make the wrong ones. That’s the honest truth. But if you are seeking an ethical practice, and truly listening for the underlying message of excellence in patient care, then you will know when it is a good fit. If something feels a little “off,” then listen to your intuition. Reconsider the offer. And then the next day think about it again. Finally, be willing to live with the uncertainty of no job or no partner for a little longer, if that is what it takes to find a great fit.

I realize that there are many who would disagree, saying that it seems the hard-driving, ambitious, supremely self-confident, borderline arrogant practitioners are the ones that really move the profession, that make the difference, that shake up the world. I would beg to differ and consider that “it seems” is the key phrase here. While these type-A personality traits are not wrong in and of themselves, in order to show long term true success, to make a lasting difference, to influence the world for good, then I would submit that these characteristics need to be subsumed to the long-term good of all, finding ways to move forward and do good while being kind, thoughtful and ultimately, a loving person.

So, what is the answer to the proposed question? Look for someone who is genuine in their concern for others’ well-being, whether or not this contributes to their own. That’s the true bottom line.

Joy Eastridge is a nurse. 

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