LoyaltyDonald Trump said that there is nothing worse than disloyalty. He said that disloyal people are no good, never will be any good and all you can do is get rid of them. So it's not as though healthcare is alone in the importance it places on loyalty. The choice for healthcare workers is between being loyal to colleagues or protecting patients - another of the conflicts of interest between providers and patients. The fact that people working healthcare are the least likely of all people to report crimes committed against patients tells you who they protect. Patients need someone who is loyal to them to protect them. No one in medicine does that. They protect each other at the expense of patients. A community that won't even report crimes committed against patients cannot make a legitimate claim for the safety of patients being their first priority. They repeat and believe that it is, but the statistics show that is only a self-serving delusion. Their desire to protect their careers and their colleagues and their businesses trumps the well-being of their patients virtually every time according to statistics like the rate at which they report crimes committed against patients. Not only do they not report crimes that have been committed, they also don't report people and situations that have a high likelihood of causing problems for future patients. Reporting is not tolerated in medicine, state and federal laws notwithstandingConsider this example. At the Jones Memorial Hospital in Wellsville, New York, Gary Ogden, M.D. was drinking the equivalent of 20 shots a day. He had been doing this for years and everyone knew about it. The nurses had talked among themselves and decided to say nothing. Not only did everyone know about it, but they had discussed it. They had arrived at a decision. They had decided to remain silent. Finally, a baby died. One nurse, Rose Mary Vossler, couldn't live with it any longer. She didn't think it was her responsibility to say anything (so much for nurses being patients' advocates), but to the appropriate person she said that she had smelled alcohol on his breath. She had hoped to keep her action secret, but people figured out who had talked. They bullied her and bullied her until she quit without even having another job lined up. For one of the reasons for why things are this way, click nurse trainingAfter she had told me about this, I asked her if she thought there that there might be a wall of silence in medicine. She had never thought about that before but supposed that there must be one because otherwise how could Dr. Ogden have gone on the way that he did for as long as he did with everyone knowing about it but no one doing anything about it. This is a typical level of awareness in medicine. When asked about a wall of silence, her own did not cross her mind. She had said that the nurses had talked among themselves and decided to remain silent. It had been discussed. It had been agreed upon. When that is not recognized as a wall of silence, even by a hero who sacrificed her career and social standing in a small community to protect us, consider how far from consciousness it must be everyone else in medicine. "The nurses had agreed to remain silent"She said another doctor in the hospital had the authority and the responsibility to do something but he said that he couldn’t because he was Ogden’s friend. Whether it is the result of friendship, loyalty, consensus or automatic, unthinking routines it still is a wall of silence and problems will not be corrected and patients will die, and even be murdered, because of it. Years of alcoholism without anyone reporting it? It is not unusual for an OR nurse to assist on 2000 operations per year. How many thousands of patients were operated on by someone who was drunk without one single one of the other people involved in those procedures reporting it? The one who finally did was mobbed and bullied and, in the end, excommunicated for it. There should be a patient safety initiative that runs to the aid of people like her. By and large, journalists learn about medicine by
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