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Our School. Our Future. Our Responsibility.
You may be dependent on SLU’s programs and processes in multiple ways: for education, training, reputation, income. What do you do when you recognize significant problems within your institution which could negatively affect all of the above? What do you do when you use the official channels for quality reporting and process improvement but meet only with resistance and hostility?
Perhaps you start to inquire more deeply, go outside of the unresponsive official channels, look for allies in similar situations, drive transparency, and spread awareness in the hopes of encouraging compliance and change.
Have you ever:
… witnessed or experienced abusive, demeaning or intimidating behavior from a physician or supervisor and felt powerless to report it, or much less, correct it?
… been less than truthful on ACGME or other surveys or in interviews for fear of retaliation, for fear that the truth would damage the program upon which you depend for your livelihood, or because you’ve been encouraged by an authority to misrepresent reality?
… been given an arbitrary, harmful and/or erroneous performance evaluation or disciplinary action with which you disagree but are powerless to counter?
… noticed a culture of hostility which interferes with the learning and working environment?
… found it extremely difficult to communicate information with attending physicians or supervisors because of a perceived disdain for you and your subordinate position in their elevated status,… especially in a way which might affect patient care?
… been blamed, mistreated, berated and/or embarrassed in a group setting for decisions and outcomes which were in no way yours? Perhaps your attending made poor choices or has a marginal skill level, yet you are the one left to hang for it in M&M while the attending sits quietly or is conveniently absent?
… witnessed blatant violations of policy, protocols, guidelines or law (e.g. ACGME, Joint Commission, institutional processes, HR, HIPAA, etc), found that no one seems to care, and that any mention of such an irregularity is summarily dismissed without acknowledgment? Or worse, perhaps you are actively intimidated into silence?
… wondered about an attending’s or supervisor’s fitness (e.g. personality, skill, thought processes, teaching ability, qualifications, professionalism, etc. ) for the role which they hold?
If any of this rings true to you, realize that it may be happening to others, too, and perhaps in ways and on scales much greater than recognized. The purpose of this page is to let you know that you are not alone.
But what do you do? What if the monitoring and feedback systems in place have been co-opted and corrupted such that they cannot address these issues? What if those that administrate these systems are blinded to (or indifferent, or impotent, or likely benefited by) the non-compliances and violations which can harm you, your cohorts, and potentially even patients? External resources and pressures may be called for. Transparency may need to be forced so that improvements can be implemented.
As practicing physicians and residents ourselves, we are collecting and posting links and resources in the hope that you will join our efforts to improve the systems upon which we all depend. If you have a link or a story to share, please confidentially contact us. Your anonymity will be preserved.
Our school. Our future. Our responsibility.
The St. Louis University Med School Compliance Project (SLUCP): Driving education, awareness, and positive change towards systemic improvement for St. Louis University med school residents, faculty, and staff.
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