The Columbia Space Shuttle Disaster

Granted, I am only a year away from finishing my postgraduate degree when I will be considered a “senior medical physician”.  However, for the time being I am still a “junior doctor”.

As part of my training scheme I have been changing specialties to gain further experience in different fields of medicine every 4-6 months.

When you continually change specialties, you are seen as that new kid in school all of the time.  You have no sense of belonging.  You are a nomad, a vagabond, a Hulk-esque figure walking off into the sunset at the end of a hard days work.

What never ceases to amaze me though, is the utter disdain that different specialties have for one another.

When I was working in Trauma and Orthopaedics, they hated everyone else in the hospital.  Medical doctors don’t take any action and just watch their patients die and give them antibiotics apparently.

When I was working in medicine, they hated all surgeons and accused them of not knowing basic medicine or even how to correctly interpret an ECG.

While I have been working in paediatrics I hear constant complaints about the Accident & Emergency doctors who supposedly keep making silly decisions and refer patients that need not be referred.

Oh, and every medical specialty under the Sun hates General Practitioners, because they supposedly don’t know anything about anything.

reentry-breakup

The Columbia Space Shuttle Disaster

Ladies and Gentlemen, let me divert your attention to the Columbian space shuttle disaster which occurred in 2003.  In this horrendous episode there was an error in the spacecraft’s wing which led to the disaster depicted above.  Afterwards there was a conversation between the Columbian disaster investigator and the chairwoman of the mission management team that went like this:

Investigator (I):  As a manager how do you seek out dissenting opinions?

Chairwoman (C): Well, when I hear about them…

I: By their very nature, you may not have heard about them…What techniques do you use to get them?

C: ………………………

The chairwoman had no answer.

It turned out that the lower level staff in this instance had insights and concerns about the wing which may have ultimately averted disaster.

My point is this.

Good decision making, especially when it comes to patient care, should rely upon listening to the concerns of your juniors and colleagues in the extended medical team (i.e. taking into account the viewpoints of doctors from other specialties).  Group decision making can be improved by promoting criticism of all view points, but especially those favoured by that specialties leader.

There are plenty of medical disasters which could have been avoided if this was the ethos of medical practice.

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