Saturday, September 15, 2007

A Conspiracy of Silence

Because health information management personnel must often pick up after a doctor the same way that a secretary is expected to "cover" for a boss, an unhealthy pattern of behavior is frequently found in the medical workplace. This dynamic mirrors the dysfunctional interplay between an alcoholic and co-alcoholic where, all too often, a co-alcoholic is afraid to point out mistakes or protest injustices to the alcoholic for fear of retribution. As a result, a conspiracy of silence develops in which an abusive personality continues to manipulate and intimidate co-workers.
Look at dysfunctional families where people are living in such a strong state of denial -- or in so much fear -- that they feel they must cover up for a child molester, a batterer, an alcoholic, or someone with a substance abuse problem. Then examine the behavior that exists in many hospitals and you will discover that a similar conspiracy of silence is often at play.
Medical Record Departments are traditionally staffed with people who fawn all over doctors and jump at their every command. If a transcriptionist attempts to send a critical note to a doctor, some of these people will sabotage the transcriptionist's effort to communicate with the dictating physician by pulling the note and preventing the dictator from seeing it because they do not want to anger "the poor doctor."

"There is a general trend to allow doctors their little indiscretions and goof ups -- and to even shield them and not confront them with any wrongdoing," sighs a veteran medical transcriptionist. "Everyone, including the doctor's office staff, seems to cover up for them in one fashion or another because they just don't want to ruffle the doctors' big egos!"

[Consciousness Raising Exercise #18]

Next: Power Corrupts

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