PracticalDermatology

Baditude=Bad + attitude. Sometimes pronounced baaaditude. “A foul, angry, or rude mood; negative personality; in the workplace, baditude describes someone with serious authority issues or an apathic, disrespectful or slacker-ish attitude.”

—urbandictionary.com

It seems more and more people have lost the battle between gratitude and baditude. We live in a world where appreciation has gradually given way to entitlement, complaints, and short-fused reactions. Maybe it’s just America, or just California, or just me…but it seems like there is a lack of restraint and sense of consequence for having baditude. Of course you can’t turn to any media source without hearing constant negativity and finger pointing. Whether you lean right, left, or not at all, there is no escape from the vitriol.

My favorite example is traffic, where the age-old tradition of waving in the mirror to thank the driver who let you merge in front pales in frequency to the guy who speeds up to not let you merge or just gives you the finger. I don’t know if everyone has become overly sensitive or short-tempered due to our ever-increasing stresses, but baditude has permeated a lot of society.

Maybe we all need to check how we are managing stress. How many of us use our phones for alarm clocks, and check texts, emails, and Facebook before we get out of bed? Isn’t that a bad way to begin the day (instead of with a friendly voice)? Of course with kids, long commutes, and other responsibilities, our time is often not our own before work, but we (Type As) keep adding stressors when we have already exceeded our bandwidth to deal with them constructively. So imagine how that contributes to anxiety and tension—basically laying out the building blocks of baditude, with a layer of fatigue on top.

Of late, the subject of burnout and its insidious nature are well documented and often a hot topic of articles and meetings (guilty as charged), but do we actually take the remedies or preventative strategies seriously? Do we see the consequences of our own baditude or do we move on before the resulting carnage settles? Take, for example, social media, where people post things they’d never say in person because they feel protected behind their screens. Behind that safety bunker it is easy to engage in philosophical arguments and make it personal, or in the case of patients, to take revenge on a clinic for any bad outcome with a cyber blow to the business’ reputation with a sense of immunity knowing HIPAA protects them. Fatigue, underlying tension, or other triggers are not typically behind this behavior—a lot of it is baditude personified.

And physicians are often just as guilty. On the “doctor highway,” there are a lot of drivers giving each other the finger rather than waving each other through. Physician social media pages are breeding grounds for baditude, where unprovoked attacks about differing philosophies on topics such as working with PAs and NPs, collaborating with industry, selling a practice to private equity, and many other powder keg issues, bring out the worst behaviors. A healthy debate is possible without groupthink where we can shake hands (virtually or in person) and agree to disagree—if we’re willing to ditch the baditude!

Last month we had a panel on how the specialty was in trouble, which promoted a lot of discussion, which was the point. It was not a place for sensitivity. It was a place for dermatologists to realize that we have to wake up from complacency and band together so that payors, poachers, and posers don’t undermine our craft. We have to keep our image strong in the eyes of patients so that our training and efforts are not diluted. This is something that the AAD Council of Communications has worked hard to do, but we can still do more, and more aggressively, for the sake of patient safety not for self-promotion. We also have to learn to show gratitude when possible—for mentors, for those who open doors for us, etc. It’s frustrating when the efforts of those who have worked to help promote success get forgotten in times of promotion when the call for collaboration and pretense of gratitude come to the forefront; this can create animosity that probably could have been avoided. In these cases a simple oversight of gratitude could be misinterpreted as baditude on both ends where both messenger and recipient have an agenda.

So how can physicians and patients alike leave our short fuses and quick responses behind in favor of benefit of the doubt and making gratitude part of the routine? Maybe we all need to revisit the roots of compassion we thought we had mastered in school and be a little more accepting of philosophical differences that are based on opinions, not facts, even if there are editorials and meta-analyses that support one idea or another. Or maybe we need to remember to express gratitude and recognition sometimes instead of just pointing out what we believe are injustices, and remember that philosophy does not have a “right” answer? In any case, we need to wave to the people who let us in a little more, and shake off the grip that baditude is slowly taking over. Easier said than done? Show yourself some gratitude when you do it.