Question

What common thread connects reformers who have sought to improve the quality of medical care throughout history and why did some of them fail?

Answer 1

The common thread that connects reformers who have sought to improve the quality of medical care throughout history is that the reformers’ views were generally counter to an existing practice or prevailing “knowledge.” Based on traditions and customs existing practice in medicine, is passed from one generation of physicians to the next. Even though there is no science to support it existing practice is so ingrained that it becomes its own truth. For example, even though Ignaz Semmelweis had empirical data to support his claim that hand washing with carbolic acid reduced cross-infections of puerperal fever to almost nil, his medical colleagues were unconvinced and ostracized him. Innovation threatens the established order, hence it is disruptive and calls into question the competence of previous practice and those who used it. Thus it is feared. Reformers may fail to appreciate the threat of their innovation or change for their colleagues and peers. Oftentimes, political allies are needed to provide support and give weight and credibility to the change(s)/innovation(s) being sought. An educative and supportive approach by the reformer will be more effective than condescension or haughtiness, both of which are likely to anger those who are being asked to change. Based on history it has been shown, even evidence and education may not persuade.