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On My Mind
September 2017

Tribalism in Medicine—Us vs Them

Author Affiliations
  • 1Division of Emergency Medicine, Boston Children’s Hospital, Boston, Massachusetts
JAMA Pediatr. 2017;171(9):831. doi:10.1001/jamapediatrics.2017.1280

Today, while having lunch in the cafeteria, it happened. Three men asked to join the far end of our table and their proximity, combined with their increasingly animated conversation, made eavesdropping inevitable. That, and the fact that “they” were unknowingly talking about “us.”

“They can’t help it,” said the first man. “That’s how they practice medicine in the Emergency Department—fast, fast, fast.” His friend nodded, and with an odd mixture of annoyance and ennui moaned, “The other day they ordered a computed tomography before they had even completed a full physical examination.” “I can’t imagine having to practice medicine like them,” said the third. Their shared dismay seemed to bond them, until an incidental glance in our direction landed on our hospital identification badges, yielding the uncomfortable realization that the “them” they were discussing was, in fact, “us.”