“In a world full of assholes, you don’t have to compete,” I was told by my First Sergeant when I took over a tank section.  “You need to meet people where they are and address your response in that place and that moment.”

We oft think of sergeants and senior sergeants (a First Sergeant is the highest-ranking sergeant in a company (imagine 90ish-150 soldiers)).  He was gruff, but he was a leader and a damn good one to learn from.

Leaders realize that people are where they are.  Do you think the person presenting to primary care or better still the emergency department is having the best day of their lives if they are there?  Do you believe there are not a ton of things that could make them less than the perfect person? If you are a provider in the real world, the answer is obvious (its yes Karen).

We too have our own place at that time and in that moment. We may have had the worst patient or best patient before this, and our expectations become based on that.  We may have an office staff that is particularly difficult and are making it difficult to do our jobs. As a hospitalist, I often must catch myself since the floor staff can be just as challenging to work with as anything (still staring at you, Karen).

One of the biggest things that we get wrong is not remembering that in our encounter.  We have an idea of what we are walking into, and we have a sense of our own mental situation.  We are professionals, and our job means going in and meeting that person where we are and forming an alliance to help that person towards wellness. Sometimes that is working on a solution, providing guidance, prescribing medications, or referring it to a specialist when we frankly don’t know.

It’s ok not to know. We learn through inquiry, and if your ego is so big, you charge into something you don’t see the cost to the other person could be deadly. Stopping to say you are not sure or clarifying the task or situation is the smart and professional thing to do.

We owe it to our patients professionally and ourselves personally to approach every situation objectively and realize where we are when meeting someone who we have no idea about where they are until we ask.

Best folks.