In health care, it can be hard to define the “big picture” issue when there are so many contributors:
Unnecessary procedures are raising costs and harming patients, medical errors are killing hundreds of thousands of people each year, and failure to implement useful technology is compromising clinical quality and patient convenience.
To better understand the root causes of professional misbehavior, underperformance, and dissatisfaction, we’d be wise to remember, “It’s the culture, stupid.”
In organizations and institutions, culture is defined by the actions, not the words, of leaders.
University presidents and deans have always railed against academic dishonesty while ensuring freshman orientations clearly spell out the student code of ethics.
At the same time, university leaders have for decades accepted multimillion-dollar checks for capital investments and endowments, often with the tacit understanding that the donor’s child will be more likely to receive a thick envelop in the mail someday.
It was the culture, not the admissions system, that blurred the line between what’s unethical and what’s illegal, and it encouraged people, both inside and outside the ivy walls, to step over the line.
Culture has the power to distort perceptions and change behaviors. When it does, the consequences can be devastating.
Technology is corrupting the culture of medicine
For the past decade, a hospital has been pioneering the use of “robots” to connect patients with their doctors, even when the physician isn’t onsite.
The concept is superb. Imagine it’s 10 p.m. at the hospital, and the nurse on duty notices a patient experiencing severe anxiety and discomfort.
The nurse alerts the patient’s doctor, who’s at home. Instead of simply phoning in a medication order to help calm the patient, the doctor wants to see whether something else might be wrong.
Enter the robot, which the nurse wheels into the patient’s room.
With a screen for a “face,” the machine allows the patient to see the doctor and, importantly, lets the physician assess the patient’s facial expression, energy level and depth of breathing.
On one hand, information technology in health care saves lives, allowing doctors to achieve higher quality, while making medical care more accessible and convenient.
We need a lot more of it.
On the other hand, technological innovations have pushed many important elements of medical practice into the background.
Throughout most of human history, there was little doctors could dο for a dying person.
In the absence of antibiotics, vaccines, and telemedicine, physicians relied on the only tools available: their compassion and empathy.
Standing at the beside of their patients, doctors delivered bad news with sincerity, kindness and a human touch.
Artists of the past have beautifully captured these moments, which depict the doctor-patient relationship at the very heart of medical culture.
Regardless of the moment – then, now or in the future – empathy and compassion are best practiced in person, not through a digital monitor.
When doctors lose sight of what’s important, when they prioritize the convenience of technology over human touch, it’s not a failure of technology.
It’s “the culture, stupid.”
The culture of medicine, like the culture of academia, is built on good intentions.
But recent news stories remind us that all cultures can be corrupted.
A great advice could be… not to forget!