Like most orthopaedic surgeons, I think I’m a nice guy and a very effective “communicator.” When I tell patients what is wrong with them and what they have to do about it, I am really clear. If they don’t understand, I can speak louder or repeat myself. When someone questions my judgment, I can explain how many certificates I have hanging on the walls of my office. It seemed to me that this attitude served me OK for my first decade in practice. At the end of each clinical session, I was sure that I had helped lots of people with my wisdom. If they were unhappy with my advice, they were free to go elsewhere.
Eventually, because I was doing so well, I was appointed department chair. It sounds like a great job. It turns out that there are some downsides. What I didn’t realize was that anytime a patient had an unhappy experience with one of our 40 faculty members, he/she would write me a letter or complain to one of my bosses.
The first time I got a letter from an unhappy patient, …
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