Tuesday, January 15, 2008

Keeping quiet can get you into hot water

Keeping quiet can get you into hot water : "Everything else was going very smoothly ... none of us wanted to upset anybody by making a fuss ... you can't change something that's generally accepted ... no actual proof of a link ... no definite scientific evidence of a raised incidence of morbidity ... it probably would all have happened anyway ... none of the other doctors seemed very bothered ... it was easier to forget about the problem. Does any of this sound familiar? Of course it does. It is the miserable and unconvincing chorus of self-exculpation that attends every single health service scandal that ever occurs. What I and my colleagues had enacted on our holidays, with characteristic professional insouciance and automatism, was classic medical bystander behaviour. We had played our traditional parts in a simulation of the prologue to systemic disaster, the sort of disaster that befalls people like us in our workplaces time and again, year after year.

It did not feel like that at the time. It felt, of course, like normality. Better than normality, positively hunky-dory. But that precisely is the problem. Apathy is a retrospective diagnosis. Had there been a serious epidemic of gastroenteritis ending in hospitalizations and a catastrophic end to people's summer break, I am sure that we would have reframed the experience very differently. What seemed at first like an idyllic holiday would have been recollected as a nightmare, and our inaction would have become a cause of deep guilt and shame. Next time, I have promised myself, I will make a fuss."

This explains why doctors turn a blind eye when they see another doctor doing something wrong. This is also the reason why most patients never complain about incompetent doctors. How will things ever improve ? If you are not part of the solution, you are part of the problem !

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