The abuse of power by any individual or organization can have devastating consequences. Unfortunately, healthcare is no exception.
Paul Hofmann, an executive with an extensive healthcare resume, believes abuse of power is as widespread in his industry as it is in other fields. Hofmann is a former visiting scholar at Stanford University's Center for Biomedical Ethics who now is a senior vice president of Aon Consulting's healthcare industry practice. He wrote an article titled "Abuse of Power" that appears in the March/April issue of Healthcare Executive, a bimonthly journal published by the American College of Healthcare Executives, Chicago.
Hofmann writes that "because potential consequences are far more severe than in other settings, abuse of power in a clinical facility is particularly objectionable and unacceptable."
Patients and families, he writes, "are exceptionally vulnerable in a time of crisis. They are apprehensive, sometimes frightened, and often intimidated by the organization's sheer physical size and bureaucratic complexity. Physicians, still at the top of the power structure in many hospitals, generally have a great deal of formal and informal organizational and personal leverage.
Therefore, some individuals in authority (physicians as well as other clinical staff) may speak and act inappropriately, but this behavior is tolerated because patients and families often feel too overwhelmed and powerless to voice their objections."
Other abuses of power involve "rudeness, profane language, promise-breaking, deception, dishonesty and sexual harassment. Less obvious forms of abuse of power tend to be subtle and therefore more insidious; these include arrogance, use of overly confusing jargon and withholding of information."
I have witnessed inappropriate behavior at a healthcare institution renowned as a center of excellence. The facility, which will remain nameless, is known all over the world for its superb clinical staff. But arrogance has reared its ugly head there.
Arrogance is another word for insensitivity. It doesn't belong in any healthcare organization, regardless of its reputation or the excellence of its clinical staff.
A friend called me to intercede on behalf of a loved one who had been admitted to this facility. My friend's father was quite ill, and his prognosis was not good.
What was galling to his family was the attending physician's lack of contact and the nurses' sullenness. The family members wanted information and assurance, but they virtually were ignored. At one point, a nurse allegedly told the patient's wife, "You're always asking questions that are none of your business." Imagine such behavior in any organization, much less a healthcare facility.
Those in authority have to be vigilant and willing to intervene when abuse of power is identified. Looking the other way or simply ignoring such situations to keep the peace can lead to further abuse and tragic consequences.
No organization can get away with treating customers badly for very long. Word gets around, and pretty soon what was known as a center of excellence is viewed as a center of mediocrity. It's a subtle shift, but it happens.
Be aware, Charles S. Lauer Publisher