Yes, there is a powerful irrational status-driven reaction against the idea that something so rudimentary as checklists could improve the work of people who are a subject of high status reverence and magical thinking. Note how even in this article, the author feels the need for pious disclaimers, denying emphatically in the part you quoted that this finding presents any evidence against the heroic qualities of character and intellect that the general public ascribes to doctors.
Of course, the fact that this method dramatically inverts the status hierarchy by letting nurses effectively supervise doctors doesn’t help either. In our culture, when it comes to immense status differences between people who work closely together, relations between doctors and nurses are probably comparable only to those between commissioned officers and ordinary soldiers. I don’t think such a wide chasm separates even household servants from their employers.
This reminds me of the historical case of Ignaz Semmelweis, who figured out in mid-19th century, before Pasteur and the germ theory of disease, that doctors could avoid killing lots of their patients simply by washing their hands in disinfectant before operations. The reaction of the medical establishment was unsurprising by the usual rules of human status dynamics—his ideas were scornfully rejected as silly and arrogant pseudoscience. What effrontery to suggest that the august medical profession has been massively killing people by failing to implement such a simple measure! Poor Semmelweis, scorned, ostracized, and depressed, turned to alcoholism and eventually died in an insane asylum. Hand-washing yesterday, checklists today.
In our culture, when it comes to immense status differences between people who work closely together, relations between doctors and nurses are probably comparable only to those between commissioned officers and ordinary soldiers.
I’m pretty sure it’s more complicated than that. My impression is that experienced nurses can generate some clout, and that (if I can believe Heinlein) experienced sergeants can have influence over new lieutenants. This is informal, and dependent both on the ability of the subordinate to be firm without seeming to upset the hierarchy and the receptiveness of the person who’s theoretically in charge.
Yes, there is a powerful irrational status-driven reaction against the idea that something so rudimentary as checklists could improve the work of people who are a subject of high status reverence and magical thinking. Note how even in this article, the author feels the need for pious disclaimers, denying emphatically in the part you quoted that this finding presents any evidence against the heroic qualities of character and intellect that the general public ascribes to doctors.
Of course, the fact that this method dramatically inverts the status hierarchy by letting nurses effectively supervise doctors doesn’t help either. In our culture, when it comes to immense status differences between people who work closely together, relations between doctors and nurses are probably comparable only to those between commissioned officers and ordinary soldiers. I don’t think such a wide chasm separates even household servants from their employers.
This reminds me of the historical case of Ignaz Semmelweis, who figured out in mid-19th century, before Pasteur and the germ theory of disease, that doctors could avoid killing lots of their patients simply by washing their hands in disinfectant before operations. The reaction of the medical establishment was unsurprising by the usual rules of human status dynamics—his ideas were scornfully rejected as silly and arrogant pseudoscience. What effrontery to suggest that the august medical profession has been massively killing people by failing to implement such a simple measure! Poor Semmelweis, scorned, ostracized, and depressed, turned to alcoholism and eventually died in an insane asylum. Hand-washing yesterday, checklists today.
I’m pretty sure it’s more complicated than that. My impression is that experienced nurses can generate some clout, and that (if I can believe Heinlein) experienced sergeants can have influence over new lieutenants. This is informal, and dependent both on the ability of the subordinate to be firm without seeming to upset the hierarchy and the receptiveness of the person who’s theoretically in charge.
Does anyone have actual information?