201612-Paterson-Roger-Dr Sep15

When a doctor is struggling is it time to re-evaluate the label ‘dud’.

While I was munching my bacon and eggs at Medical Forum’s Doctor’s Drum, my brain searched for a more helpful label and I eventually plucked one from my everyday practice as a psychiatrist. Many of my patients struggle with interpersonal relationships and one word I use in this context is ‘Mismatch’.

I say something along the lines of, you and your partner/colleague/boss are ‘mismatched’ at the moment and, quite possibly, in the longer term.

201612-square-peg-round-holeThey may well have been a good ‘match’ at some stage but for now something is not working very well. The key aspect is that it’s not the fault of just one person. It’s more that something in the interaction is not quite clicking and the fault lies BETWEEN the two parties.

The great advantage that doctors have is they have a choice in seeking out an area of medicine which they think will match their personality type. It makes things easier for all of us if we can find an area that dovetails with both our strengths and our weaknesses.

But sometimes, after trying a number of different medical fields, a doctor may have to concede that medicine may not be a good ‘fit’ and it’s time to pursue an alternative career. It would be more preferable to find this out in medical school, and this does happen. But in a broader sense all medical students should be encouraged to frankly appraise their attributes and deficiencies.

Of course they should not be made to feel like ‘failures’, but rather as a square peg in a round hole and encouraged to look for a square hole rather than endure an interminable process of carborundum.

In terms of encouraging a ‘mismatched’ doctor to seek more suitable pastures it would be useful to reflect on just how the situation came about in the first place. Is it all down to a personality type ill-suited to a medical career? Did it develop due to an unsupportive system or difficult colleagues? Are there personal issues, such as ill-health or burnout?

Whatever the reason there will be some doctors who may need to have their ‘mismatch’ clearly pointed out.

This can be a difficult process and needs to be approached with sensitivity. These individuals may need to be ‘pushed’ to take some action to address their deficiencies. For example, further training, peer support or some constructive advice relating to interpersonal communication. For some it may be best to simply move on to a different environment or even a different career path where their strengths will be ensure a more positive ‘match’.

Even with the best of intentions, some doctors will defy any form of ‘reframing’ and continue to underperform. If that’s the case, at least the system can say it did its best before pressing the ‘Reject’ button.



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