Why The Experts Matter
There is little doubt that the United States is suffering through a crisis in leadership. When Donald Trump was president, his cabinet seemed to churn with new members frequently. The good people left and were supplanted by those who would tell the president what he wanted to hear. Loyalty trumped competence. The same goes on in corporate America and academia and to a large extent explains poor decision making and unethical conduct.
In the attached opinion piece from The Wall Street Journal on January 28, Harvard economics lecturer and senior fellow at the American Enterprise Institute Rachel M. McCleary tells the story of the men who tried to stop the launch of the Challenger space shuttle in January of 1986. Roger Boisjoly and Arnold Thompson, engineers at Morton Thiokol makers of the shuttle’s rockets, tried to convince those higher in the chain of command that the weather that day at Cape Canaveral was too cold for the O-rings on the boosters to function properly. Lawrence Molloy was the NASA solid-rocket booster manager and he did not want a fourth postponement of the launch despite the warnings from the most knowledgeable members of his team. The rest is history.
Boisjoly and Thompson were not complicit with the general thought that the launch, the one with the teacher as President Reagan queried when he heard about the explosion, go forward at all costs and not heeding common sense. Boisjoly’s reward for having been right was his dismissal from Thiokol’s investigation team. This is typical. The individual who is “disloyal” or perceived by his bosses to be disloyal, is punished even when the advice they offer is correct. The squeaky wheel no longer gets the grease. He gets the boot.
This is one I get as it happened to me once too, fortunately with far fewer implications when I resisted a non-profit clinic’s plans to ignore physicians’ demands for more time with patients. I too was fired because my tactics of resistance had gone as far as the board of directors and the clinic leadership could not tolerate that.
Anyone who is in a complex organizational system might find himself or herself confronting a reality he or she knows is wrong. It is not just the fact that a bad decision or decisions will be made and bad consequences will ensue if no one speaks up. The struggle is how you assert your knowledge of a pending disaster and keep your job. How do you oppose foolishness without appearing disloyal?
The Challenger disaster was a completely preventable tragedy. All the leadership had to do was listen to the technical experts. Today, in academic centers, as leadership drives for greater revenue through greater patient volumes, as off-work time for faculty is filled with catching up with the electronic medical record, and as academic, research and teaching time is invaded by longer clinic hours, the mission of the academic medical center is being lost in a haze of income statements, insurance forms, and documented faculty burn-out. The only way this trend reverses is that those who know best, the faculty and staff, make it clear to the leadership that the institutional plan going forward is incompatible with the safe and efficient operation of an academic center with a traditional mission of stellar patient care, cutting-edge research, and a commitment to the education of the next generation of physicians and nurses.
If you agree, and believe that the future of the academic medical center is being guided by people with poor decision-making skills and lackluster vision, speak-up. There is no substitute for being right. The only challenge is how to be heard and keep your job. It’s tricky, but it was never more important since that day in 1986.