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Picture Perfect

Jeff_2Jeff Wonoprabowo -- Like many Americans and non-Americans alike, I have been following the 2008 Summer Olympics. It's been fun watching Michael Phelps grab a record 8 gold medals, Misty May-Treanor and Kerri Walsh dominate on the sand, and the "Redeem Team" (I'm not sure who came up with that nickname) led by Kobe Bryant and Lebron James handle business in the early preliminary rounds.

But it's also been amusing to read the news about how Beijing has focused on putting on the perfect show. First there was news that some of the fireworks outside of the Olympic stadium were faked using the wonders of modern technology. Then I read that the cute little singing girl dressed in red was, well, just cute and little. She wasn't actually singing. The real singer wasn't "cute enough" and so the red-dressed girl was told to lip-synch.

It looks like China has been doing a whole lot to convince the world that all is well and perfect in their country behind that bamboo curtain. And maybe it is. But most likely it isn't. Of course, I have yet to find any place on earth that is perfect.

The whole idea of projecting perfection, though, reminded me of some of the things we discussed in class. One professor noted that doctors have this strong desire to stick together. They want to give a colleague the benefit of the doubt. As a result most doctors are very slow to offer any criticism, often exercising their right to remain silent because they weren't present during the procedure.

I think that giving the benefit of the doubt is great. False accusations can lead to devastating consequences. But there have been instances when certain doctors no longer deserved the benefit of the doubt. An extreme situation is described in the book Blind Eye by James Stewart. In that book, Stewart writes about a doctor that got away with murder.

Would transparency in the medical field be beneficial to both doctors and patients? I'd like to think so. But sadly, with our current litigious environment, complete transparency would be a nightmare.

And so, doctors may very well have to continue painting that picture perfect image of medicine.

August 17, 2008 in Jeff Wonoprabowo | Permalink


Curious that lawyers can be blamed for the problem. Because in most states in the U.S., the code of ethics for attorneys requires that lawyers who know of a violation of the conduct code report it, or are guilty of a violation themselves. Self-policing is not the perfect answer, and collegiality aside, wouldn't it improve the situation?

Posted by: Paul | Aug 20, 2008 4:06:18 AM

sure transparency would be so beneficial to the patient and to the medical field.....but just think about it, nobody likes admiting their mistakes, most people just blame it on others...so for an unprepared doctor transparency would be a total nightmare....'cause we have to admit that eventhough some people have a medical degree they should've never have graduated, i've had my share of fellow classmates to prove my point...however we have our own teachers and fellow classmates to thank, because those people usually pass difficult courses by cheating or 'cause the profesor felt sorry for them...so yeaah transparency would be beneficial to get rid of those not fit to practice medicine

Posted by: monika | Aug 20, 2008 8:10:11 PM

There is transparency and then there's *transparency*. It's one thing to report an obviously incompetent physician. Exposing every single issue is another. A doctor my make an incorrect diagnosis, not because he or she made a mistake, but making a correct diagnosis may be very difficult in some situations. Medicine is not the same thing as fixing an engine. Very skilled physicians often have to make judgment calls before diagnostic tests can be run. Would you want someone with hindsight to critique every decision you made yesterday?

Posted by: Jon | Aug 26, 2008 8:34:25 AM

Transparency is tough. While not all physicians may agree with one another, the one thing that can be agreed upon is that the journey to M.D. is a long and tough one and I believe that it is an experience that despite disagreements, binds everyone together. Everyone has gone through those tough years and knows what it has taken to get as far as they've gotten. To report someone and have that possibly result in the doctor's license being taken away is a terrible consequence. It may be appropriate in some cases, but it's a terrible consequence nonetheless and something that I believe most physicians are reluctant to be responsible for. If a physician was deliberately harming patients its easy to pull the trigger. But what if its just a mistake? Maybe they're having a really rough time? Momentary lapse of judgment? Honest mistake? So many questions to ask yourself before you decide to let the dagger fly. And just where do you draw the line?

It's important to have transparency. Every agency, being, and group needs some degree of oversight or check. But like so many other things in medicine, the lines are never drawn clearly and I don't believe they can be. Faced with all this self-doubt when placed in this situation, its easy to see that while there is a need for transparency, there is no structure set up for it in many hospitals and medical care centers. By the way, this is a separate issue, but I think tort reform would greatly benefit transparency.

Posted by: Johnson | Sep 9, 2008 8:50:36 PM

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