Dumb Thinking

Consider this:

“First-year doctors will be allowed to work 24-hour shifts in hospitals across the United States starting July 1, when a much-debated cap that limits the physicians to 16 consecutive hours of patient care is lifted, the organization that oversees their training announced Friday.

The Accreditation Council for Graduate Medical Education said the change will enhance patient safety because there will be fewer handoffs from doctor to doctor. It also said the longer shifts will improve the new doctors’ training by allowing them to follow their patients for more extended periods, especially in the critical hours after admission.”
(Source: https://www.washingtonpost.com/news/to-your-health/wp/2017/03/10/first-year-doctors-will-be-allowed-to-work-24-hour-shifts-starting-in-july/?utm_term=.9fccda88129b)

This is old, old thinking that goes back to the turn of the last century. That was a time when doctors believed that handwashing was a waste of time. (Look up the struggle that Dr. Semmelweis ran into. Then look up Dr. Lister)

The outdated theory behind having doctors work insanely long shifts is based on faulty thinking and probably greed. The hypothesis is that doctors working under stress and fatigue will learn to make better decisions under duress.  What really happens is that doctors make mistakes when they get too tired. Shouldn’t that be obvious? If this practice is so beneficial, why not have all doctors periodically work 24 hour shifts? Under this reasoning, wouldn’t that sharpen their skills?

Personally, I think this is greed-based. It reminds me a bit of college sports. An athlete can be used to make piles of money for a college, but they can be punished for accepting a meal. That’s why so few athletes complete college with a useful degree. Another topic for another day.

We know that close to 100,000 people die every year because of medical mistakes. (Institute of Medicine published the famous “To Err Is Human” report)  Why add to that by having doctors work beyond human limits? Stupid.

I see dumb thinking at nearly every business that I evaluate. I recently concluded work with a client that operated under such flawed thinking that I doubt they will be in business at the end of this year despite being in the most rapidly expanding industry in the country. At this company, the top paid employee was writing procedural manuals and corrective action reports. Problem is, the company continued to make very costly errors despite lengthy reports analyzing failures. Dumb thinking. If the person in charge of quality spends more time writing reports about quality than he does supervising and thinking about quality, there will be more trouble ahead. Dumb thinking.

Why do we cling to outdated or dumb concepts? The reasons are legion. They range from lack of knowledge to ego to greed. Yes, greed. It is erroneously concluded that it is cheaper to “stay the course” than to re-evaluate processes.  Dumb thinking. As loss after loss pile up, we still believe that we should continue on the same path because it’s cheaper than change. Dumb thinking.

Consider the war in Afghanistan or Iraq. How long is long enough to fight in Afghanistan? McCain said that we will need to be there for 50 years. Really? We need 10X more time than we needed in World War 2 to defeat the Taliban? (Who we armed in the first place)  Dumb thinking.

I know the term “dumb thinking” is harsh but there is no other word for it. Dumb thinking at your business could be holding it back from the success you want. This applies to large and small businesses.

When was the last time you stopped everything and took a good look at where the time goes at your business? Is it well spent? Is there a lot of waste? Do mistakes recur? Is the business as profitable as it could be?

We can reduce dumb thinking by taking time to think.

Chris Reich, TeachU