Entry 1400, on 2012-06-14 at 17:02:51 (Rating 4, Comments)
According to American author and essayist, Edward Abbey "a patriot must always be ready to defend his country against his government." It's one of my favourite quotes and one which I have mentioned in this blog before. I have also mentioned the idea of extending it to include defence from other power structures.
For example I would say that every employee should be prepared to defend his clients against his corporation (or company or organisation). Or every doctor should be prepared to defend his patients against his hospital or health authority.
A recent case in the news here in New Zealand is a good example. A doctor from the far north of New Zealand has resigned because of a disagreement with the authority which runs the practice he worked in. The disagreement was mainly about the doctor treating people for free when they couldn't pay. A specific example involved him giving advice to one person who was accompanying another person he was treating.
This doctor is very highly regarded and has had very positive, effective ideas in the past yet he was forced to leave because he didn't fit in with the accounting requirements of the organisation. That's disgusting. Not only was the management prepared to stop people being treated and potentially suffering a worse outcome (possibly death) in the future, but they also ignored the distinct possibility that a $50 value of free treatment early could save $5000 of intervention in the future.
Plus they ignored the moral requirements of the Hippocratic Oath, but of course managers and accountants aren't bound by moral rules. If they were moral they probably wouldn't be managers or accountants!
I realise that there is a possibility that giving free treatment is a privilege which might be abused. The person getting the treatment might have enough to pay but just be too greedy to, or they might spend the money they saved on medical treatment on cigarettes or alcohol instead. But I don't think that possibility should be used as an excuse. The advantages of treatment for those who genuinely can't afford it surely outweigh the disadvantages of possible abuse.
My thought on the subject is get rid of some of the bureaucrats who forced the doctor out and use the money saved by not paying them to fund some free treatment. Seems like a good idea to me! In fact I suspect that if all the layers of mindless bureaucracy were stripped away from the health system that medical treatment could be made much cheaper and that the occasional free consultation would be perfectly viable.
It's not only in the area of health that this sort of thing happens. In my own job (IT support and programming) I was forced into a "cost recovery" system many years ago and since then some people would contend that the organisation I work for has become increasingly bureaucratic and out of touch with what our clients really need. So the option then naturally arises of bypassing procedures and using "creative record keeping" when it is necessary to do the best job for clients.
The same issue has recently been discussed in relation to New Zealand's ACC system. There has been discussion over what should be the main priority for its employees: customer service, following the specifics of the law, or following the dictates of management. The answer seemed to be a balance of all of those things which I entirely agree with.
Of course for many the standard answer would be that an employee's obligation is to do what management wants him to do. It should be up to management to make sure that those instructions automatically lead to the best legal and service outcomes. But few people would see this as being anything but a convenient fantasy. And the equally unrealistic fantasy that problems of that sort can be solved through standard management procedures can also be rejected.
So yes, everyone should be prepared to stand up to authority to ensure he is really doing what's right. I would go further and say that unless a person finds himself in trouble for that sort of behaviour occasionally he probably isn't doing his job very well - unless he is very skilled at subterfuge, of course!
So continuing my theme from a few blog entries back (Who Are the Heroes? on 2012-05-31) I would say that this is another example of how the best people are the ones who refuse to play the corrupt games they find themselves involved with. If the game is unfair then just make up your own rules!
So in summary what I think is this: if you are a moral and competent person it is up to you to defend what's important from the forces of orthodoxy, mediocrity, immorality and corruption.
Comment 1 by REA on 2012-06-15 at 08:45:45:
If the four hoursemen of the apocalypse are War, Famine, Pestilence and Death, would Orthodoxy, Mediocrity, Immorality and Corruption be the four footsoldiers of destruction?
Comment 2 by OJB on 2012-06-15 at 13:48:34:
Well yes, they would in a way. In fact they are more fundamental than the hoursemen of the apocalypse because they are their cause.
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