Trickle-down economics is a policy that gets a lot of heat from certain sides of the political aisle. But apparently trickle-down leadership is a must for healthcare.
One of our program leaders made a comment about how he would not work at a program where risk management answers to the team’s legal counsel. The implication of this, was that if risk management was not reporting to the CMO or CEO, the hospital had philosophy of safety that was an anathema to a culture of patient safety.
When asked what could be done if our institutions risk management reported to the wrong agency, the answer was succinct, “find work at a different hospital.” When asked what could be done if that wasn’t an option, the quote “culture kills the best strategies” came up again.
Without support from administration and leadership, changes are improbable at worst and ephemeral at best. Practitioners in… Continue reading
In the line from the story of “Lewis Blackman,” one of the narrators mentions that there is a “perception” that it “is bad to call for help” in medical culture. There is no “perception.” It is a reality.
There are many expectations of providers that go without saying, to be upstanding professionals, compassionate, resistant to fatigue, empathetic, and un-jaded. These features, virtues essentially, are non-negotiable. They aren’t even talked about beyond medical school admissions, as residents we are simply expected to act this way at baseline. But there are two cardinal sins of residency, laziness and ignorance.
Often of the first things asked about a resident is are they “good:” a surrogate of the two measures, not lazy and not ignorant. A lazy resident is an involved problem, but an ignorant one causes a whole separate array of issues. They require additional oversite, their treatment decisions are in questions, and… Continue reading