Dealing with difficult people

The importance of good work etiquette and a healthy work environment is staggering. The difference between work environments can be quite broad–the kowtowing and formalities necessary which one is dealing with doctors’ surgeries (for instance) versus the fun and lighthearted atmosphere of the university institute. as examples.  But it is the very difficult situation brought about by two conflicting personalities that fail to see eye-to-eye that really concerns me.

The atmosphere that one’s colleagues creates is beyond one’s control–this must certainly be a universal finding, across professions and cultures. I wonder if it isn’t like an arranged marriage. After all, one is being thrown into a situation without any background information, and hopes to be respected and even cherished, but wants to avoid conflict or abuse at all costs. (I was about to direct you to an etiquette website, but after reading it, I feel it is a little naive and Pollyannaish.) We will all likely encounter difficult people and having the skills to deal with them would be more realistic than teaching everybody to smile all the time.

Something I read in Psychology Today struck a nerve with me:

“One clue that a person is attempting to intimidate or manipulate you is the use of unpredictable, or protean, behavior—acts that are random and seemingly out of the blue. A dictator keeps his minions guessing—and scared.”

It is important to arm ourselves against harassment in the workplace, but equally important to realise that some people will not change–nothing has changed them yet! Sometimes, I think, the best move may out the door and towards a more supportive environment. And this is where I differ with the Psychology Today article, which advises you to try to be understanding when the boss calls you a “screw-up.”

Update, April 2009: I have recently done a search of the blogosphere and I am still coming up short on blogs or websites that offer advice on how to deal with difficult workplace scenarios that is not completely biased towards protecting the employer and their interests.

Bedside evidence – is it too late?

Where does evidence belong? An “Evaluation of the Five Most Used Evidence Based Bedside Information Tools in Canadian Health Libraries” suggests that of them (UpToDate, BMJ Clinical Evidence, First Consult, Bandolier and ACP Pier), clinicians preferred UpToDate and Clin Evid even though “neither product generally includes levels of evidence.” The author suggests that if a clinician wished to use these tools then it would be prudent to critically appraise the information they get before using them to guide patient care.

However, these are bedside tools we’re talking about here – there is not time, and indeed is this the place, to start appraising information. Clinicians consistently seem to like UpToDate because it speaks their language and gives relatively detailed guidance on what to do – it’s not really evidence-based, but that does not seem to do it any harm. It does not leave a clinician hanging with a Cochranesque “more research is required”. This is not to criticise Cochrane as it is a fundamentally different beast; surely no-one seriously thinks that Cochrane is suitable for bedside use, or that UpToDate is seriously an evidence-based resource (do they…)?

Arguably, trying to leverage in evidence “at the bedside” is the wrong place to do it; evidence needs to be introduced higher up the chain, where commissioning takes place, where patient-journey pathways are drawn up, where guidance is written and acted upon. We need to be ambitious and get evidence in up at the top. To try and ‘tack on’ a bit of evidence at the bedside is surely too little too late…(?)

Enlightenment values strike back

A spirited defence of the scientific method, in the face of recent criticism (e.g. see previous post re: plagiarism). The author wishes to enter the post in the Carnival of the Elitist Bastards, a project that aims to “put intellect back in the public discourse.” Good for them.

Plagrarism; it’s only undergrads, isn’t it?

After the great embarrassment of Dr Raj Persaud, the “copy-paste, yes it’s all my work” psychiatrist loved by the BBC and Richard and Judy, among others, it’s reported in Nature that “About 1,000 potential incidents of fabricated, falsified or plagiarized data in scientific research may go unreported every year…” It’s not just undergraduates discovering the wonderful world of plagiarism then.

Enterprise/intranet search still creaking

Enterprise search is meant to be bringing the quick, precise and highly specific results of your average Google internet search into the process of searching your local hard-drives, email, servers, intranet etc, isn’t it? Not according to most users of such systems, the IWR reports that they’re disgruntled: “[a survey] found that nearly half (49 per cent) of those surveyed were unhappy with the current state of play and felt that finding company information was a difficult and time consuming progress.” Though to be honest, that’s not as high a figure as I thought it would be!

Online health records; all for the good?

Online personal health records: You might just have noticed that there is much talk around about Google and Microsoft’s online personal health record offerings. It has been assumed, particularly by those of us in the industry, that demand will be huge and that it will be a major boon for the new legions of ‘informed’ patients. A few recent posts have however asked a) are these Google and MS products really good for the consumer, and b) does said consumer actually really give a monkey’s? Are these products fulfilling a previously unmet need, or are they made, like many of the less successful web2.0 projects, with the “build it and they will come” model?

The Krafty Librarian gives us an anecdotal story of how her partner got into a right anxious muddle by asking Dr Google what his test results meant (he had viewed them online, rather than had them given, and explained to him, by a health professional), while the Health Care Blog asks “What are the circumstances for using a PHR and do the benefits outweigh the perceived risks?”, and fails to come up with a satisfactory answer…

Another “top ten search hints” list

Is it possible to have too many of these “top ten search hints” lists? No, I don’t think so either…

Bio-linguistic statistical correlations in Pubmed, apparently

e-LiSe (short for “e-Literature Searcher” apparently) is yet another website that interrogates PubMed/MEDLINE. This one “uses PubMed database of scientific abstracts as the source of data and a novel bio-linguistic statistical method (based on Z-score), to discover true correlations, even when they are low-frequency associations”, whatever that means. It “…is also capable of finding names of researchers correlated to the information searched by the user. It can function as a name reference engine, answering questions like ‘who is working on specified subject?’ or ‘what are the coworkers/collaborators of a certain person?’” Well, who can argue with that?

One of my hats is that of managing editor for an academic journal that makes copious use of expert commentary and critique, and as a result I do from time to time spend much of my day looking for such expert commentators. I therefore tried e-LiSe to find frequent authors in a field and, you know what, it was rather helpful. Also, when preparing for searches etc., I think it might well be a useful tool for finding synonyms and related terms.

Give it a whirl. It doesn’t look very pretty, but then it does seem to have been made by a bunch of academic coders who probably rarely see the light. If you’re interested in the technical details behind it (the Z-score etc) then take a look at their recent paper here.

PubMed Faceoff; weird

This is so weird – PubMed Faceoff. Basically, it allows you to search PubMed and have the results represented as a set of human faces.

The article? The journal? What is the basic unit of information?

Some interesting thoughts on what the natural unit of health information is (bringing in parallels to how our thoughts about tracks and albums changed with the advent of digital music), and its impact on the journal of the future… the author writes: “… what’s the “natural unit” of health information? Is the article to an issue of a journal what a track is to an LP record? After all, clinicians never come to our library seeking an issue- they come in search of an article…”