Shamsa Kanwal, M.D., is a board-certified Dermatologist with over 10 years of clinical experience. She currently practices as a Consultant Dermatologist at https://www.myhsteam.com/ Profile link: https://www.myhsteam.com/writers/6841af58b9dc999e3d0d99e7 Why this matters: Patient care moves faster when juniors manage up with respect, data, and small workflow wins. I have several hospital-based examples that improved collaboration with senior physicians. Introducing updated guidelines without friction: As an early-career attending, I drafted a one-page isotretinoin safety bundle from current guidance and asked a senior to co-review it. Framing it as a time saver, not a rule change, led to adoption. We built an EMR order set with pregnancy testing, contraception counseling, and lab timing. Outcome: fewer pharmacy call-backs and more consistent documentation across clinics. Making consult plans stick on rounds: Our dermatology recommendations were getting lost after morning rounds. I piloted a 60-second SBAR "skin summary" with a templated plan that began with three action verbs. I walked the senior through two trial weeks and gathered nurse feedback. Result: fewer pages for clarifications and same-day implementation of cellulitis look-alike plans and steroid tapers. Smoother biopsy to pathology handoff: Labeling questions were delaying reports. I mapped the handoff with a senior surgeon, added bedside lesion photos in the EMR, standardized requisitions for site, size, and differential, and pre-labeled jars before clinic. The senior co-signed the change, which normalized adoption. Pathology turnaround became more predictable and repeat calls dropped. Five-minute safety huddle: During a heavy admissions week, I proposed a brief midday huddle to surface any patient at risk for treatment delay. I brought a simple checklist and asked the senior to lead the first two days. We prevented missed anticoagulation holds before procedures and reduced late-day scrambles.
When I was in training, I noticed that complex reconstructive cases often lacked input from oncologists and radiologists before surgery. I suggested to my attending that we bring those perspectives into a shared tumor board discussion, and at first, there was hesitation about adding another layer of meetings. But once the board started, outcomes improved and the senior surgeons saw firsthand how coordination reduced complications and re-operations. If a younger physician wants to manage up effectively, I'd say frame these ideas as ways to make the senior team's job smoother rather than more complicated.