The Benefit Of Buddy Systems in Medicine

buddy system medicine

Starting a new job in Medicine can be exciting, but it can also be very stressful. How often have you started a new rotation or a new job and felt a bit lost on the first day? Have you ever had an experience where you can honestly say that you “hit the ground running?” Assigning a workplace buddy can help ease the transition for new employees into their new roles can be very beneficial for all involved, especially during the onboarding process.

What is a Buddy System?

Buddy systems have been used in other industries and schools for many years and proven to be effective ways of ensuring that employees get off to a good start. This has all sorts of benefits to both employee and the organisation.

Simply put a buddy system involves assigning a new employee a workplace buddy. The buddy is an existing doctor who guides the new doctor through the first few weeks or months on the job. In Australia we have started to see the rise (or in some cases rebirth) of buddy programs, sometimes also referred to as mentor programs. In particular it is now common in the State of NSW, for the second of the 2 weeks of Intern induction to consist of a “buddy week”, where the new intern gets the chance to understudy a finishing intern in their first new rotation. Whilst these buddy weeks are quite popular they do have their limitations. The key one being that because the relationship is very brief it only really permits a small transfer of knowledge and in particular doesn't afford the new intern doctor a chance to reflect and ask questions of their buddy about the hidden curriculum of the workplace.

Evidence has emerged that longer relationships between new employees and existing employees in Medicine can help reduce stress, and improve morale, sense of support and job satisfaction.

Buddy systems should include a formal documented process that outlines the buddies’ responsibilities as well as what items they should cover over the first few weeks or months of employment. The buddy system should also encourage the new employee to share tips, tools, knowledge, and techniques they have learned about the workplace. A buddy also potentially gives the new doctor a psychologically safe opportunity to offer confidential feedback about how their onboarding process is going. For these reasons the closer the buddy is to the new doctor in terms of peer relations the better.

Why Implement a Buddy System?

The last thing we should hear from a doctor on their first day is “Nobody knew I was starting today.” At the end of their first few weeks in the job we want new interns to feel that they made the right decision to study medicine and for other doctors starting new jobs we want them to feel that they accepted the right position.

First impressions are key. The initial enthusiasm that interns experience to have “finally made it” can be either lifted or ruined, depending on their start. What happens during the first few days can determine the long-term perception of the job and the organization. Studies have shown that a large number of employees quite within 6 months of taking up a job. Often citing a poor onboarding process or lack of clarification about their role as the key reason for doing so.

Regardless of whether there is a formal process in place or not, onboarding is going to happen; the real issue is the quality of the experience. When onboarding is done well it sets up new doctors for long-term success. If an orientation consists of handing the new intern a pile of forms to fill out on their first day, then there are going to be future problems, which is where a buddy system may come in handy.

Implementing a buddy system can be part of an effective onboarding program that provides new doctors with a way of resolving questions regarding work processes. Some of which may be difficult to predict and / or hard to deal with in a formal orientation seminar. This socialization and support can make a big difference.

In particular, a buddy can help with the last 3 of the 4 C's of onboarding: Compliance, Clarification, Culture and Connection.

The buddy system is not only valuable to the new doctor. Its obviously also an opportunity for existing doctors to develop skills as a mentor and may foster the early development of a range of people management and leadership skills.

From a bottom line point of view a well executed buddy system will likely reduce the number of doctors leaving a hospital or organisation, particularly early. And this will save the hospital a lot of money in re-recruitment costs.

But at a deeper level buddy systems can improve employee engagement with the organisation which can be a vital component of instilling a positive workplace culture. Which in itself is likely to lead to better outcomes in terms of both patient care and cost.

Benefits To BuddyBenefits To New Doctor
RecognitionOne-on-one assistance and single point of comfortable contact
Expand NetworkJump start on networking
Opportunity To LeadSmoother acclimation
Fresh PerspectiveKnowledge of “how things really get done”

What Is a Buddy?

A buddy is someone who partners with a new doctor during their first few months of employment. He or she is a colleague assigned to assist the new doctor to get through this period. They can provide insight into the daily activities of the hospital and help the new doctor fit in more quickly.

An effective buddy is a good communicator, has an interest in the development of others and is the type of doctor the organisation hopes to emulate (fits with the value system). They will generally take the new doctor around their hospital and orientate them and introduce them to key people who can help them out.

A Good Buddy

  • Is known as a good performer and well regarded;
  • Is willing and able to mentor others;
  • Has the time to be available;
  • Knows the new doctors job;
  • Is a peer of the new doctor;
  • Has good communications and interpersonal skills.

A good buddy should be a good representative for the culture and values of the hospital and organisation and be familiar enough with the formal and informal organizational structures to be a reliable source of information.

Buddies Should Not Be

A buddy is definitely not a supervisor and probably should not be a mentor (at least in the first few months). This helps to make the task of the buddy more limited and definable. Learning how to be an effective buddy can be useful as a foundation step to learning how to be a mentor or supervisor. The buddy is are available to answer straightforward questions about how the hospital operates. It is important to make clear to both the new doctor and the buddy that the buddy is not being asked to develop the new doctor and is not accountable for performance. This makes the buddies role easier in terms of being able to support the new doctor without fear of reprisal.

If a doctor does not want this extra responsibility, then they should not be assigned the buddy role. Some doctors simply don't want the responsibility or are not ready. Worse, some doctors are not well suited temperamentally for the role. A doctor who is known to be someone who gossips at work is probably not a good fit for a buddy role. The last thing a new doctor wants to hear about is gossip and speculation in their first few weeks.

What Do Buddies Do? What Training and Support Do They Need?

Buddies should be given the skills and knowledge to be able to:

  • Teach or tutor, for e.g. explain an unfamiliar task;
  • Explain tactical matters, such as how to submit a time-sheet and where the pathology forms go;
  • Talk about and explain the hospital's structure, written as well as unwritten rules;
  • Share insights on how things are done in the hospital;
  • Involving the new doctor in social activities, such as coffee and lunch with new team.

Buddies can benefit from some training and support in their role. But probably the best thing that can be provided is a suggested list of task and a timeline for completing them.

Generally speaking the buddy is encouraged to meet more frequently with the new doctor e.g. daily for the first week, weekly for the first month, monthly for the next few months and gracefully exit from the relationship. Its helpful to set a solid time frame for when the relationship finishes (6-months is generally good).

During the first few meetings the buddy works to help with urgent and practical questions. As the relationship matures and the new doctor finds their feet the explaining turns into more of the “why things are done this way around here.”

Tips for Being a Buddy

If you are asked to be a buddy, here are some tips that can help you:

  • Keep a list and timetable of what things the new doctor needs to know or be shown;
  • Be patient. Relationships take time to develop. Your new colleague is unlikely to open up to you until they have spent a bit of time getting to know you and you have earnt their trust;
  • You are not the expert on everything, instead think about who else can answer questions you don't know the answer to and introduce them to the new doctor;
  • Don't try to cover everything at once. Remember the new doctor is going to feel overwhelmed in the first few weeks. So try to avoid cognitive overload. Leave the deeper discussion till later;
  • Stay positive. New doctors will grow into their roles in time with appropriate support and confidence is infectious. Maintain a positive, teaching attitude;
  • If possible try to identify the new doctor's personality and communication style and adapt;
  • Be open and don't judge. Your new doctor is relying on you to be a safe place to get answers to their many questions.

Remember. Despite the best efforts of the manager who asked you to be buddy. Sometimes buddy relationships don't work out. Don't be afraid to approach your manager to express concern and/or suggest an alternative buddy.

Troubleshooting Problems With Buddy Programs

There are some practical problems with assigning buddies in hospitals. Firstly, there are often not enough experienced buddies to go around. Especially with 100+ new interns starting all at the same time. Secondly, often those who are identified to act as buddies are taking leave or moving on at the same time as when the new doctors are arriving.

One way to get smart about this issue is to gather information and consider the level of readiness of the new doctors. There are likely to be some in this group that require more support than others. Typically some may have already studied as student or worked in the hospital already and have a level of familiarity. These new doctors can probably more safely be assigned less experienced buddies and you can save your best buddies for the completely new doctor.

Setting up regular training and check ins with your buddy group can identify gaps and issues. This can be triangulated with sessions with the new doctors themselves.

Facts

Cognisco in 2008, estimated that UK & US businesses lose $37 billion annually because employees do not fully understand their jobs. According to their white paper, “$37 billion: Counting the Cost of Employee Misunderstanding.”

Summary

Creating a buddy system for new doctors requires some time investment and buddy choice should be carefully considered. However, this is not a difficult or expensive option to implement.

Make sure you've chosen a willing and effective buddy; create some documents to support them and the new doctor. Set an end date for the formal buddy relationship. Watch for the things that do not work so you can guide both the experienced and new doctors.

A buddy system can dramatically reduce the time a new doctor requires to be productive and aid retention. An additional benefit of a buddy program is that it allows for corporate knowledge sharing and positive recognition for the buddy.

References:

Cooper, J. & Wight, J. (2014). Implementing a buddy system in the workplace. Paper presented at PMI® Global Congress 2014—North America, Phoenix, AZ. Newtown Square, PA: Project Management Institute.

Sonia Chanchlani, Daniel Chang, Jeremy SL Ong and Aresh Anwar. The value of peer mentoring for the psychosocial wellbeing of junior doctors: a randomised controlled study. Med J Aust 2018; 209 (9): 401-405. || doi: 10.5694/mja17.01106 

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Anthony Llewellyn

Anthony Llewellyn

FRANZCP, MHA, GAICD | Medical HR Expert and Coach. Anthony is an experienced health public sector executive, medical educationalist and coach. Anthony is an expert in Medical HR. He has reviewed numerous CVs, chaired and conducted over a thousand job interviews and provided advice to a number of employers and Colleges about selection processes. Anthony's background: Consultant Psychiatrist and Medical Manager with 20 years’ experience as a medical practitioner in public health services in a range of roles. From 2012 to 2016, Anthony was the Medical Director of the Health Education & Training Institute (HETI), involved in overseeing a number of network training programs. He is also a Senior Lecturer at the University of Newcastle’s School of Medicine & Public Health, and Year 5 Psychiatry Coordinator. He is currently completing a PhD in Medical Education, exploring personal learning environments in the intern training space. Anthony recently delivered for the Royal Australasian College of Physicians a Best Practice Guide for Trainee Selection into Employment Roles Anthony was born on Mouheneenner land in Hobart (Tasmania) and pays respect to the traditional owners of lands he lives and works on, and elders past and present. His two most important roles in life are proud husband and proud father of two boys.

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