Dear Pat responds to “I’m the Boss”

29 Apr 2018

Dear Pat,

My intern is a tall, white male. Every morning on rounds I introduce myself as the Chief Resident and state the roles of everyone on the team. However, patients continue to direct their questions and concerns to him and look to him for the plan. My intern is uncomfortable with this, and appropriately redirects the patients to me. How do I better establish that I am the Chief Resident? I know this is something that I may face for the rest of my career, how do I stand up for myself without letting this drive me crazy?


I’m the Boss


For this month’s “Dear Pat”, we have two AWS council members – Drs. Amalia Cochran  and Marie Crandall – share their strategies in response to “I’m the Boss”.


Dear “I’m the Boss”,

These situations can be challenging. Some cultures or age groups struggle with identifying women as surgeons, and that is likely contributing to the obstacles you are encountering. I want to start by telling you “Great Work!” for being meticulous about introducing your team and everyone’s roles to patients and families. It can be easy to forget that they don’t know who is who and what they do. I also want to praise your intern for being #heforshe in what sounds like his consistent efforts to redirect patients and families to you as the team leader. It’s important to realize that your team is doing things well, and that this is a broader societal problem that you cannot fully “fix” on your own. What you can do is continue to educate your patients and do your job well. Also, I would encourage you to see if there are system options that could help out. Are there white boards in the patient room in which team member names and roles can be written? I know a few places  include photos with the names of their healthcare team, which might also be helpful in your situation. I would encourage you to explore these options with attendings, nursing, and administrative leadership; it might help minimize your frustrations, and could also improve patients’ satisfaction with care.

Good luck. It’s still not always easy, and you are doing a great job.


Amalia Cochran MD, FACS, FCCM


Dear “I’m the Boss”,

This is a common source of frustration for women residents AND attendings, as well as doctors from underrepresented minority groups in medicine. I cannot say there is a universal solution, but there are some things that worked for me, as a smaller, young-looking woman. First, you have done exactly the right thing by engaging your team; if you want to be the point of contact and the person leading the discussion with the patient, walk into the room first, have everyone stand behind you, and say something like, “Hi, it’s Dr. XYZ and your trauma team.” That tacitly puts you as the leader without diminishing your junior residents’ roles. Also, hold eye contact, answer all questions, and use body language. I have found that standing with a slightly wider stance (picture military, if you will), and a slower, deeper voice that projects across the room has been very helpful. Finally, I don’t know your patient population, but my patients would not be familiar with what “Chief Resident” means, so I rely on body language and confidence. Consider providing a definition of your role. If these things aren’t natural for you, see what works for you (and let us know!), but it’ll definitely get easier with time.


Marie Crandall MD, MPH, FACS

The Association of Women Surgeons (AWS) is excited to bring to you a resident and fellow focused blog titled, “Dear Pat”. “Dear Pat” answers questions about issues pertinent to surgical residents and fellows, such as navigating through residency, applying to fellowship, family planning, and handling difficult situations on the job. Questions may be submitted by residents and fellows anonymously and will be answered by AWS council members. This monthly blog is published the fourth Sunday of each month. We want to hear from you,  if you are interested in submitting your anonymous question, use this link. 


Our blog is a forum for our members to speak, and as such, statements made here represent the opinions of the author and are not necessarily the opinion of the Association of Women Surgeons.

One Reply to “Dear Pat responds to “I’m the Boss””

  1. I am so thankful for AWS. And thank you for helping to make these concerns feel validated by addressing them so openly.

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