Posts Tagged ‘doctors’

Modern Healthcare’s “Don’t Ask, Don’t tell”

August 1st, 2010

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The July 19th edition of Modern Healthcare had a very revealing article by Melanie Evans entitled “Don’t ask, don’t tell.” The cut line under that title was “A third of physicians in a  study don’t feel obligated to report impaired [fellow] docs.”  Ms. Evans went on to describe the fact that the word impaired refers to drugs, alcohol or mental illness.  The study was from the Journal of the American Medical Association and it queried nearly 1,900 physicians.  Having been involved with the management of hospitals for over two decades, the results of this study shocked me.  Not because I didn’t believe it was possible; not because I didn’t believe there could be a problem but because it was clearly not my experience.  Yes, there were impaired physicians, administrators and staff members, but the programs available to them were comprehensive, thorough and unending.

If the question was posed, “Is there a problem with drugs, alcohol, and mental illness among physicians?,” my answer would have been  yes.  The same, however, is true of administrators, staff and employees.  None of those exposed to an environment that intersects with life and death issues on a daily basis and that requires the incredibly long hours necessary to keep the  proverbial “wheels on the bus” is without risk of these problems.  Add to that the relative ease of going  from one “friend” to another to get the prescription that is needed, and we have created a potential formula for disaster.

The seriousness of the outcomes derived from this series of questions is not something that any of us “in the business” is in any way ignoring.  It is real.  It definitely could result in injury andor death through medical errors.  So, the question becomes one of management, monitoring and self-policing.  The airline industry pays very close attention to the impairment of their pilots. Why?  Their crashes are typically not between one pilot and one passenger.  They are large, emotional events that impact literally thousands of lives.

When will the medical community begin to embrace the same standards as the airline industry?  It seems to me that we are currently “on  the move toward that objective now,” and as the public and government put more and more pressure on the healthcare industry to be transparent, it will become harder and harder to hide those shadow surgeries that went wrong  or those mis-diagnosed cases that could be traced back to impaired professionals.

Image credit: Edie Falco as Nurse Jackie - (c) Showtime Networks

The Modern Healthcare article ended with the statement that doctors “need more education on programs that evaluate and manage treatment and monitoring for impaired doctors.”  I agree . . . in this case, more is better, but how many “Nurse Jackies” (i.e., the hypothetical impaired employees) do we have flying low throughout our facilities as well?  The healthcare industry needs to pay attention to all of its impaired at all levels.

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How Do You Keep the Music Playing?

February 9th, 2009

When civilizations are evaluated, there are numerous indicators that are used to demonstrate their relevance, their contributions to the world, and their donations to the future. As a young musician, one of my college professors predicted that our culture would begin to decline as a military, economic, and artistic world power. He pointed toward what he described as primary indicators of this decay, and he saw the decline of music in our schools as one of those indicators.

Overall, this professor was more than concerned about the role of public education in the future of our country and once described our form of public education as an experiment that would eventually prove to be ineffective. He saw the effort as a misguided attempt to squeeze all different shapes, sizes, and types of personalities, intellects, and skills into a single classroom, which he called a “melting pot of mediocrity.”

That professor also used to teach us about the writings of Marshall McLuhan from the University of Toronto who indicated that television would change the manner in which we lived our lives. His book The Medium is the Message made us all begin to look at the influence of television on society.

McLuhan described the fact that in visual space we used to think of things as continuous and connected. In either the auditory senses or the sense of touch, there are only resonances. There is no real continuity in our other senses. The fact that we have become the visual wo/man, through television, and that visual orientation has produced a collage that is neither continuous nor connected, has resulted in the reality that even our visual perceptions have lost their continuity.

It is well-known that music nurtures both the right and left sides of the brain, and that those who study music have intellectual opportunities that literally may not exist for those who don’t. The challenge is not just one of music as entertainment, but music as part of our intellectual training. So the question is, as in the James Ingram song lyric, “How do we keep the music playing?”

Young music teacher Nick Jacobs meets musical hero Maynard Ferguson What does this all mean? In 1972, my professor indicated that we were leaning toward a different type of society that would learn, participate, and act in a different way. One of his greatest fears though was that, due to this lack of continuous connection, those who would take charge of our educational systems would not recognize the importance of music as part of education and that music would begin to be downgraded, minimized, and even dropped from public education. Thus reading, writing, arithmetic, and the arts became reading, writing, and test scores.

If we look at the dramatic decline in participation in music education over the past 30 years, he was not far from wrong. The answer to the question of how this has impacted us as a society may not be totally clear for a few decades, but as we look across the overall educational landscape and see these chasms of deprivation from exposure to the arts that already exist, it seems relatively obvious that we have and will pay the price for ignoring those subjective, intellectually stimulating programs that spawn creativity and lead to new and better ways to form our futures.

Remember, from science fiction comes science, from dreams come creations, and from fertile minds come our professional careers. The high-quality drama teacher, vocal instructor, or orchestra director who helped many of us find our way to where we are today is many times not employed anymore, and last week we saw the arts cut once again from the stimulus package. In 1987, I read that more physicians had studied music as a discipline than any other single concentration in both high school and undergraduate work. Will tomorrow’s physicians be nurtured by music, and if not, at what cost to society?

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