You do get to do this when you're an attending.
By the time I was a chief resident, I was on better terms with the IM dept than the attending in charge of psychiatry consults. They actually agreed with me that the psychiatrist in charge of it was something of a lazy bum because they too tried to work with him and he never showed up to meetings.
I worked with the IM dept on a few things they always wanted a psychiatrist to help them on, such as doing presentations for the IM residents, working on on some committees for the IM residency. I did all of this because I was having some fun but also because I believed in what I was doing--assisting our colleagues to improve education and patient care.
So after a few months of being chief, I started telling residents to say "no" to some of the consults so long as they cleared it with me first, but they had to explain why. E.g. "The patient is not appropriate for a consult because no one interviewed her using a translator as required by state law. Once that is done, then we will consider a psychiatric consultation if you request one again." Several of the consults when patients didn't speak English were, in reality, attempts by nursing staff for the psychiatry resident to sit there with the translator and get the information they were supposed to get themselves.
We bypassed the psychiatry attending. I didn't mind it because it was getting me and fellow residents out of BS consults, I knew the IM dept would back me because I was on good footing with them, and our dept head knew the attending was pretty much worthless because I addressed the issue several times and was told under-the-table that keeping that attending in-line was on the order of pulling out teeth. I figured if he wanted to complain about me, he'd look even worse since both the IM and psychiatric dept told me they'd rather have me working there than him.
I wouldn't advise this type of thing for most of you residents. Doing such could be professionally dangerous.
I mention all of this because the point is several attendings were those medstudents and residents that you are convinced will totally suck as doctors, yet these people will graduate and find jobs---some as teaching attendings. Most in medical training ascribe a level of mysticism and respect to some attendings that really are not deserving of it. I do, however, advise you keep in-line and on your best professional behavior, not just out of self-presevation, but because it's something you ought to do because it's the right thing.
