I do not normally remind myself as being among a species that first lived in the caves. But there are moments when the inexplicable behaviors of the medical fraternity take me back thousands of year to an age when the first wheels were being perfected.
To understand this let us travel back in time and imagine you are one of the cavemen who came to hear of a wonderful invention, the wheel by which people are able to cover distances or move goods with less effort. You haven't seen it but you are excited and bring back the wonderful stories to your own tribe. Then you begin to create your own wheel based on the rumours that you have heard and of course your own imagination. With more than full confidence in your abilities, you begin to cut out wooden pieces and join them in a shape resembling a square. You fit them on a sledge or whatever and conduct the first trial runs in moving a not so heavy rock. Sadly the first time it doesn't work and you are a bit upset. Then you think harder and come up with a 'smarter solution', you are convinced it needs sharper corners. You try again, sharpening it as much as you can but again it doesn’t seem to get things moving. You go back in the cave, drink some more goat milk, think harder and then eureka, you believe that all you need is to punch some holes and try it again. And this can go on and on until you may just maybe get it right. All the while you could have just walked 2 nights to see it for yourself and replicated the invention. But no, no, no you would not do that for you don't believe you need to. You know that you are very clever after all you were the first one in your generation to catch a monkey by its tail. Or maybe you came from a proud tribe that did not have a tradition of looking for guidance from the other cavemen. Whatever your past, many full moons may pass not getting it right. Or you could be lucky with ideas and finally shape out a nice round wheel that can carry your proud lady to the yearly wheat festival in the neighboring village.
How stupid you might think! Well the truth is that this is what happens everyday in many clinics or hospitals around the world. And if you have worked in a clinical environment, I am sure you have seen what I am talking about but have not probably understood the implications. But I couldn't avoid the implications because my job often was to make it right. The wheel may have become IVF or angioplasty, the full moons have become the calendar on the PDA but unfortunately some of the caveman persist in scurb suits.
Over the last ten years I have been involved in starting up new clinics. There are always challenges like meeting budgets and spatial constraints. There are difficulties in hiring the right people, getting the equipment set up right and there are issues in coordinating the teams and people involved to get it all right. But to me these are the simpler challenges, the ones that we can overcome. What I find harder to overcome are the hurdles in human behavior, mainly the stubborn determination to recreate the wheel if I may say so. The doctor often refuses to walk the 2 nights or does not like to be told what to do by the other tribes.
We are fortunate to live in an age where there is knowledge and skill available in abundance yet some choose to behave as though they live in a vacuum. They prefer to learn by trial and error often ignoring the fact that error is costly. It is more than just not being able to roll the fat lady to the wheat festival. They ignore the reality that not doing it right means the unlucky patient is forced to experience the nice doctor’s extra long learning curve.
No comments:
Post a Comment