Why Weaponizing Professionalism Is A Form Of Cancel Culture
By
Leonard Zwelling
One of the nuances of the Texas law banning abortion after only six weeks of gestation of the fetus is that the main form of enforcement is to have individual citizens turn in people they think are breaking the law. This, by the way, would include potentially guilty Uber drivers who knowingly transported pregnant women to abortion clinics after the sixth week of pregnancy. I’m not sure how the Uber driver would know these facts, but he or she is liable under the law.
Governor Abbott and the state legislature have thus deputized average citizens to become the abortion police in lieu of the usual authority for such matters, the real police. This is a terrible idea on many levels, not the least of which is that it turns innocent Texans into rats and weaponizes regular citizens.
I believe that the drive toward “professionalism” at MD Anderson has similarly empowered classified employees to turn in misbehaving faculty (or supervisors) rather than pursue more traditional routes of conflict resolution between, let’s say, a doctor and a nurse. The drive to “professionalism” is thus a form of cancel culture with the faculty the primary people being cancelled.
The practice of modern oncology is harder than ever. There is so much more to know and learn than was ever the case when I trained. There are more therapeutics and more complex drug interactions and adverse effects. Supportive care has advanced dramatically and opinions on how to treat any given patient may be varied. And the patients are sicker, especially the in-patients. That a nurse may disagree with a doctor’s orders is nothing new. That the nurse elevates this disagreement to a charge of bullying is something else again.
Furthermore, the press to see more patients due to the financial imperatives from the highest reaches of the organization have taxed the faculty and classified staff including nurses alike. Burnout is a real threat despite all the “programs” initiated to combat it. In the end, it’s those on the front lines that bear the burden of irate patients and treatment failures.
People, being imperfect, will lose their tempers in the heat of a clinic or a late-night call. In the past, this was a given. Now it is cause for HR actions, accusations of a lack of professionalism or bullying, and in some cases, dismissal from MD Anderson. Thus, the nurses have been turned into the professionalism police and the arbiters of cancel culture. Doctors cowed into suppressing their ire when their orders are not followed feel like they have targets on their backs. This is nonsense and comes straight from the top. I am not excusing bad behavior, simply explaining ways it might occur. This new imperative from above puts the determinants of what is errant actions in the hands of the perceiver and the accused faculty member guilty until proven innocent. Harassment is when anyone says it has occurred. This can be a fraught arrangement.
MD Anderson has become a place where nice is more important than smart. This is really dangerous. How dangerous? First, no patient comes to MD Anderson because the faculty members are nice. They come to get the best care possible from the most knowledgeable physicians guided by the best science. If the doctors and nurses are personable—great. But if a busy clinician is harried on a given day when a patient flies in from California and that doctor is a bit short with a new patient or a nurse, that is not cause for an accusation of bullying or a moment to drag everyone into a law suit.
Sure, civility counts and should be rewarded. Repetitive bad behavior should not be tolerated, but turning one group of employees against the faculty in a drive for something elusive like professionalism (you’ll know it when you see it) is a really bad strategy and should end. Now.
You never know what kind of review you could get on the internet suggesting that you behaved less than professionally. Use Google about some prominent faculty members to find out. I did. Illuminating, but not in a good way. Check it out.
2 thoughts on “Why Weaponizing Professionalism Is A Form Of Cancel Culture”
Encouraging, and sometimes rewarding, employees to “rat” on doctors or nurses is one of the tenets of creating a fascist culture. Fascism is not a concept that we expect in America. But, it is worth perusing its definition and its consequences. Focusing power in a few hands, suppressing opposition from professionals, and funneling wealth into a power elite have all seeped into American medicine in our lifetime.
Having been Chief Medical Officer for a large multi specialty practice (1037 employees), I worked with the administrative and business side of medicine. The “head shed,” as I called the nonphysician healthcare leaders, were always concerned about controlling physicians or nurses who spoke up too much, challenged their edicts, or got angry in the workplace.
To create a more positive workplace, we adopted the concepts of “Just Culture” management. We focused on discussing behavioral issues openly and then using professional counselors to help disordered docs and nurses with their self awareness and ability to handle difficult situations without losing control of their tempers and language. In two out of three cases, it improved the behavior. When it did not, we respectively asked the physician or nurse to resign instead of being fired.
We need a just culture, not a cancel culture.
Jeb: I couldn’t have said it better. Kudos to you for making it work in your practice. LZ