Recently, I had read several posts by Doctor Michael Langan, a physician that has worked at the Harvard-affiliated Massachussetts General Hospital, and I noticed that he had made relevant observations about the practice of medicine that I am interested in sharing with others. Similar to myself, Dr. Langan espouses the idea that objectivity is important in medical education and healthcare. When we replace objecivity with surrogates such as academic title, the quality of patient care is at risk of drastically declining unless there is close monitoring. Sadly, such close monitoring and oversight is not routinely present. This lack of oversight may be partially secondary to the 1986 Healthcare Quality Improvement Amendment (HCQIA). The HCQIA granted immunity to all senior hospital personel in the name of "patient safety." However, as the recent Veteran's Affairs Scandal has taught us, review by a third-part of the leadership is essential for truth, quality, and when absent, lives can be lost. For example, one soldier died from brain cancer while waiting four months to be seen at the VA Medical Center. Dr. Lanagan kindly granted me permission to share his posts, from his website, http://disruptedphysician.com on this website. This post is the first of a series of illustrative and insightful posts into how overzealous medical regulators without any vested self-interests paradoxically harm patients, physicians, and society. The zealot doctor relentlessly pursues the most irrelevant minutia of others, selectively excuses their own transgression and competency failures, and is paid for inflicting harm on other physicians and society. In addition, these zealot doctors have no active oversight and need give no account to others regarding the basis of their decisions or their rationale. Similar to many things in healthcare, the immunity granted by the 1986 HCQIA started with good intentions of protecting doctors on peer-review committees. However, as the V.A. Scandal illustrates, they did not predict the devastating outcomes of granting completely immunity to people that may not always have altruistic intentions. Your comments and suggestions are welcome.
Apropos to the rise of the “impaired physicians movement” and its current manifestation in the illegitimate, irrational and misguided “physician health and wellness” programs.
Originally posted on Maral Cavner's WordPress Blog:
Persuasion Theory – The Belief Hierarchy Theory by Maral Cavner
While all of the theories included within persuasion theory are interesting to me, especially in their novelty, the belief hierarchy theory was the one that resonated with me the most and also the one that seemed like the most realistic theory in terms of achieving its stated outcome. For example, I have a hard time believing that the silver bullet theory, which from my understanding is the theory that you can send such a well constructed message that will convince (kill) as much (or as many) as you need it to, is actually a realistic possibility for a single constructed message. I say this primarily because of the wide variety of opinions and the accompanying variability of conditions that each individual person could possibly require in order to be convinced of anything subjective. In contrast, the belief hierarchy theory, which…
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