Training in anger: how not to communicate with one's medical seniors

Meyer and Mendelson (2) have identified four critical situations which influence the interaction of consultant and consultee, namely, (1) inappropriate setting; (2) threat through disease and death; (3) character disorders; (4) family and social pathology. Feeling states of hopelessness, pessimism and despair are induced in both consultant and consultee and may lead to a breakdown of their working alliance. It is postulated that the breakdown is programmed by the physicians' basic attitudes towards coping with dependency needs are ignored by the faculty of not being patient-oriented (5). Covert or open hostility towards the faculty is manifested (10). Basic professional needs are not discussed with one's medical seniors who are seen in anger. If liaison medicine is to become effective, its proponents have to direct their attention towards attitudinal learning during undergraduate study. This will require supervised exposure to patients needs, assuming increasing responsibility, individual and faculty feedback.