Most of grew up believing that being a Doctor or being in the medical profession meant you were a notch above everybody else. A whole lot of us aspired to be a doctor too. And the image of a doctor in our minds was that of a dedicated, committed, highly intelligent and qualified person who considered her profession as noble. It was difficult to doubt a doctor in fact the thought did not even occur to us. After all we were putting our lives in their hands.

And if you look the profiles of doctors and surgeons and nurses they are people who wanted to do something good and had worked very hard to get where they were. I am sure they never started to study medicine with the thought that they will be part of an exploitation system in future.

A system which simply plays on the circumstances of the patients and is totally insensitive to the fact that every patient is a human being first. Patients only became “numbers” How many tests? How many surgeries? How many admissions? And so on. Why people begin to compromise their integrity? People, who didn’t need to, people who are like Gods. What Happened?

I put it down to three core reasons

  1. Social acceptance of dishonesty as well as ease of getting away. In a tacit way we all support compromise on integrity as long as it suits us. In fact we lot of times envy the people who are in positions where they can exploit. This damages institutions and highly skilled professionals by making them believe that is ok to cheat.
  2. Too much value attached to easy money, we all love it. Large commercial entities like pharma companies are only interested in profits so they push doctors, surgeons to become part of their agenda to just earn. And since people with money are largely admired easy money becomes very enticing.
  3. Limited or non-existent intolerance for such acts till it hits us personally. As a people we accept too much from hospitals, schools and any other institution simply because it seems like too much effort and we feel we will suffer if we raise a voice. And then one fine day we ourselves become the victim of this laxity. Do you think the exploitation by hospitals would have reached this proportion if collectively people refused to put up with some practices? No. It was easy money feeding more easy money.

Added to this is the basic human nature. And what is the basic human nature when it comes to dishonesty. Let us look at some experiments which reveal the basic nature of people and why cheating becomes an option.
Psychologist Dan Ariely Professor at Duke university did an experiment where college students in a classroom-like setting given 20 mathematical matrices to solve. They were told to solve as many matrices as they could within 5 minutes and were given 50 cents for each one they got correct. Once the 5 minutes were over, the participants took their worksheets to the experimenter, who counted up the correct answers and paid out the correct amount of money. It was found participants on an average correctly solved 4 matrices.

Ariely then introduced a condition that made cheating possible. In this case once the participant were done they were asked to check their own answer sheets, and after checking they were supposed to tear the answer sheets and  Once the participants were done they would self-report the number of correct answers to collect the money. Once the possibility of cheating was introduced, participants claimed to solve 6 matrices on average – two more than the situation when cheating was not possible. Ariely concluded that given the chance, lots of people cheated – but just by a little bit.

Ariely also found out in his experiments that if the reward per correct answer was significantly increased people had more difficulty in cheating as it caused a greater amount of conflict within themselves to cheat for a big amount and still feel good about themselves.

“On one hand, we want to view ourselves as honest, honourable people. We want to be able to look at ourselves in the mirror and feel good about ourselves (psychologists call this ego motivation). On the other hand, we want to benefit from cheating and get as much money as possible (this is the standard financial motivation). Clearly these two motivations are in conflict. How can we secure the benefits of cheating and at the same time still view ourselves as honest, wonderful people?

This is where the rationalization comes in. The more we’re able to rationalize our decisions as morally acceptable the more we are open to doing the act. The usual excuses help rationalization, everyone is doing it, there is no other option, if I don’t I will suffer in my career and so on.

Then the external factors come into play, the huge business entities create a picture of lavish life style to all working in the medical field and push them into situations which kind of makes them the take the first step towards compromising Integrity. And as is obvious taking the first dishonest decision is the key. Each subsequent decision becomes easier and easier. And then one fine day we have created a monster, all of us together. This monster then starts to affect us not only in the medical field but everywhere else. We have to start by saying NO at personal and collective level. No works! #nohospitalscheating

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