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Rudeness as power

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Re “When Doctors Are Rude Without Repercussion,” Sept 13: I remember my first trauma resuscitation as a medical student: loud voices, anger, ridicule, a scene of frenetic activity. This never occurred in my experience as a Los Angeles City Fire Department paramedic in South Los Angeles.

The authors of the study believe that abusive incidents are more likely to occur in stress-filled units with life-and-death issues. But veterans of major fires and numerous combat veterans from three wars taught me teamwork, decision making and leadership. From my experience, and with respect to my mentors and teachers, the nature of live-or-die work does not lead to abuse.

Patients also have some culpability. They seem to judge the quality of their doctor in proportion to how onerously the doctor treats staff.

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As long as we equate rudeness with power and power with good medical care, we will have this problem.

Dr. Daved Van Stralen

Department of Pediatrics

School of Medicine

Loma Linda University

Loma Linda

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