Courage and Discretion: Two Essential Qualities

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Do doctors have the courage to say no hospitals that give patients used inhalers?
Do fear control doctors since bad laws were passed that upset the balance of power between hospitals and doctors!
Are doctors able to advocate for their patients any more?
Could the deterioration of the health care in united stated in the last 20 years is due to fear and silence of the physicians?
Can the organization that claim interest in health care quality conducts a research to study the fear culture among physicians?
Did HCQIA-1986 law that was written by a hospital lawyer caused the deterioration of the health care system we are experiencing now in US by subdue physicians to hospitals and powerful peers?
Did we give the rat the key of the storage room when we empowered hospitals over physicians? Was the health care system shifted by the power of the hospitals from what patients need to what bring more money and improve the bottom line of the hospital even if it is not needed by the hospital? Could this discrepancy explain the current paradox of most expensive health system in the world but worst system in all quality measures among 12 developed nations?
When are we going to wake up before it is too late?????????
From a physician who experienced the struggle and dared to say no!

fighting for my patients and the integrity of medicine! of WV 8:37PM July 21, 2008

powerful and important, both for individual and organzational integrity and trust which are important lubricants for success @ both levels!

JJ of PA 12:38PM July 21, 2008

On Courage:
I've been pressured to lie, cheat, steal and bribe in my professional career. Looking back, I have come to regret only those times when I caved in to the pressure. Justification is much easier in the short haul. "I'm just following orders, so I'm not really responsible." "It's not really that big a deal."
Yeah, you can lose your job if you stand your ground, but you will definitely lose your self respect, and very likely the respect of those who mean the most to you, if you don't.
On Discretion:
I cannot count the times in my life when I wish I'd kept my mouth shut. I can count on one hand, and still have fingers left over, the times I wish I'd spoken up. Foot-in-mouth disease runs epidemic in my life.
Where walking this fine line between courage and discretion gets real sticky is its requirement for a functioning moral compass - not a very popular topic in today's tolerance-focused society. Espousing any system of right and wrong is eschewed as being intolerant. Yet we howl at the latest Dilbert comic strip series as Dilbert quickly rises to management stardom with his damaged moral compass.
The fact is, we can't have it both ways. And it takes real guts in a values-neutral society to take a stand when it really matters.

Ken Ferry of IN 9:54AM July 21, 2008

Mr. Wade's second point is very thoughtful and something not often enough discussed. If you want others to trust you in matters of loyalty, sensitive information and judgment, there is no substitute for exhibiting by example the class of subjects you ARE NOT known for bringing up and talking about.
Not gossiping about yourself is a clue you don't gossip about others either.
His first point,about courage "against the machine" so to speak, is fine too. But most people unfortunately can only afford a modicum of that if they read the statement they sign embracing employment at will and "agreeing" to be fired for "no" reason.
There ought to be a citizen uprising against that over-reach language that has been shoved at us by corporations, and I'm constantly amazed it isn't in some liberal's political platform. It has the "bad public policy" effect of dampening precisely the courage that Mr. Wade exhorts us to have, and we've been swallowing it whole since Reagan. Are we mice, or what?

Daniel David of NM 2:23PM July 18, 2008