I was a fifth-year medical student when inter-professional rivalry first hit me in the face. I no longer remember what spurred the disagreement but I distinctly remember how it left me feeling; angry, confused, and with a sour taste in my mouth. I remember wondering if I was supposed to feel guilty and why I even felt the urge to wonder about that. Inter-professional rivalry is an open secret in healthcare. From doctors and nurses to laboratory scientists and physiotherapists down to students and the aspiring, we look away in pretence as though if we don’t acknowledge it, it can’t be a problem. Healthcare professionals should, however, know better. After all, the most debilitating diseases are those left to progress untreated.
We counsel patients and tell them about possible complications of their diseases, things that could go wrong if they do not receive appropriate care. We break it down into early and late complications or into complications to self, others and society at large. The dangers of interprofessional rivalry are best appreciated from the latter point of view. To kick off, we’ll be going through some of the complications to self.
Inter-professional rivalry creates a breeding ground for dire problems such as low self-esteem, feelings of hatred, dissonance in the workplace, pride and inability to admit mistakes or concur to superior suggestions, persecutory or grandiose delusions, depression, and so on. For healthcare workers, there is little, if anything, to be gained. It takes a job that should be about saving lives and makes it a tension-filled battleground of unspoken grievances and lost camaraderie. It becomes less about the patient and more about pride and sensibilities. Healthcare professionals end up no longer seeing each other as comrades in arms, fighting against diseases but rather as warring factions under the obligation to oppose one another. This forces patient care to take a backseat whenever inter-professional cooperation is required.
As a result, patients suffer. Rather than professionals focused solely on improving their health, they are left with angry personnel unwilling to work with one another. They are forced to go through redundant back-and-forths for what should be easily forgiven blunders during inter-professional referrals. They find themselves pandering to the egos of these professionals in a bid to access care faster. In advanced cases, patients may even receive less than the best level of care because they are connected to a professional whom the current managing healthcare personnel considers a rival.
These will, unchecked, escalate to affect the society as a whole. After decades of pushing for a shift towards patient-centred clinical methods, it would be appalling for something as surmountable as rivalry to take healthcare away from this hard-won path to one where the professionals are more focused on outdoing one another. Over time, the damage will accrue and productivity, health and the quality of life of the society will fall.
These are but the tip of the iceberg that may sink the healthcare titanic if interprofessional rivalry persists unaddressed. Nothing is ever solved by doing nothing. We preach about checkups and treating diseases early before complications occur. It is time to take our own advice. As we advance, healthcare workers need to be mindful, openly dialogue, and find solutions to tackle the festering disease that is interprofessional rivalry.
