There should be a law, or a rule, or a requirement. There should be something!

April 1, 2006

Are are all those rules and requirements really for the best?

Ever wonder what went through the minds of committee members when they made all those rules? You know what I'm talking about: the rules that dictate how we hire and fire employees, communicate with colleagues about patients, and are educated and trained as physicians-as well as just how much we have to disrobe to be screened before an airplane flight. And on and on.

I've been on some of those committees, and I suspect most of you have, as well. Whether a committee has authority over practice groups, hospital staff, medical societies, or citizens, it seems to want to force the world to be a better place by establishing rules, regulations, and requirements.

Now, I'm sure that every one of those rules sounded like a good idea to the people who created them. It does make sense, for instance, that patient information be under the control of the patient and not available to anyone without the patient's permission. But did anyone on that committee stop to think of all the paperwork and delay that would be created in trying to protect the transfer of information to people who really need it so that the patient could get effective, well-informed care?

I'm not suggesting that we should eliminate the rules or the committees that developed them. It's just that I long for the days when we assumed that people would do the right thing just because it is the right thing, without having to complete the paperwork or check the bylaws. The problem, of course, is that the right thing seems not to be obvious, or worth the trouble, to some people, some of the time.