title: "Sweeping up after the parade": professional, ethical, and patient care implications of "turfing".
abstract: "Turfing" denotes a patient transfer or triage from one physician to another when the care of that patient feels more troublesome than it is worth. A widespread phenomenon in medical training programs, turfing appears to allocate patient care to meet physicians' rather than patients' needs. Although turfing reportedly causes inter-physician discord and inter-specialty stereotyping, its deeper consequences are poorly understood. Turfing is an interpersonal conflict masquerading as a medical issue. After examining turfing alongside other patient-related slang, I analyze the distinction between "the turf," a person, and "to turf," a practice. Several explanatory models from medical practice are explored in order to illuminate turfing's implications for medical professionalism, ethics, and patient care. I suggest that a physician's medical specialty or practice type--that is, professional culture--may link to that physician's degree of altruism. If so, then what it means fundamentally to be a physician might vary across medical specialties. Such a link calls for a new notion of cultural competence, one that physicians may apply not to patients but to each other.
authors.affiliation: Center for Bioethics and Humanities, SUNY Upstate Medical University, Syracuse, NY 13210, USA. caldicoc@upstate.edu
authors.forename: Catherine V
authors.initials: CV
authors.lastname: Caldicott
mesh_terms: D003695:Delivery of Health Care / Q000592:standards*; D006801:Humans; D010360:Patient Transfer; D011369:Professional-Patient Relations; D014218:Triage / Q000941:ethics* / Q000592:standards*