For the Health Of It™©, Volume 2 #16: The Answer To “What’s Wrong At The VA?” Is Staring Us In The Face
We are proud to publish this guest letter by Irwin Rubin, PhD, Founding Member of Veritas Health Care and Master of things that have to do with fixing Health Care Institutions, Re-Humanizing Health Care and Team Development in Health Care.
Dr. Rubin’s letter is below.
Treating the recent unconscionable situation uncovered at the VA with personnel shake-ups/resignations, AG Investigations, Congressional Hearings, impassioned Presidential Speeches will not solve the problem! Indeed they are most likely to have iatrogenic consequences…they will make the underlying problem worse! Nor is the only organization facing this situation. The painful fact of the matter is that the root cause of these kinds of situations is staring us in the face…any and every time we look into a mirror. Ask yourself a simple question if you think not!
If you were in a meeting and your manager, for the third time interrupted someone before they were finished speaking, how likely would it be that you’d ‘very politely’ lean forward and say something like the following: “Excuse me X, you may not be aware of it but Y hasn’t finished making their point yet.” For centuries, people just like you have responded to exactly that ‘hypothetical situation’ with responses that ranged from nervous laughter to shocked disbelief—“Who would be so stupid as to exhibit such potentially ‘career limiting/resume generating behavior towards their boss!!!”
We together, by our acts of omission and commission, have created an organizational world where “withholding, speaking ‘politically correct,’ putting spins on problems, and or just plain lying about the truth are ‘business as usual.’” We together have created organizational cultures with ‘unwritten rules’ of what constitutes ‘good/safe’ behavior. Unwritten rules that result in the fact that the single greatest cause of death in this country is being admitted to a hospital for care…the ‘conservative’ equivalent of a 767 jet crashing, burning and killing everyone aboard…every single day…for an entire year! And the documented root cause very often has to do with how the staff communicate—or don’t communicate—with one another, and not for the condition being treated. Let us not forget that these same unwritten rules resulted in millions of automobiles being left on the highways to run with potentially lethal consequences. Or the same unwritten rules that Irving Janus documented in Group Think decades ago that almost resulted in JFK ordering nuclear weapons to be fired at Cuba. (History will tell us if the presumed ‘threat of weapons of mass destruction’ suffered from the same dis-ease.)
As the old saw goes, when we point the finger of blame at someone/something else, three of those fingers are left pointing directly at the unexamined root cause of the problem. Until we together start to learn together how to be honest with one another, we will face the responsibility for consequences…together.
Irwin Rubin, Ph.D