One element of federation
theory – a political construct this blog has promoted as a guide in formulating
a civics curriculum – is the goal to achieve a federated citizenry – hence the
name of the construct. By wishing this characteristic
on a populous, one is aiming at encouraging a sense among a people that they
view each other as partners. In turn, that
reflects an ideal and that ideal holds that if an advantage befalls one
citizens, it befalls all of them. And the
same can be said of disadvantages.
Before one can approach such an ideal realistically, a lot must
be in place – one does not intelligently just think that all his/her fellow
citizens’ interests, their honesty, and their general aims are honorable enough
and fall in line to reasonably allow such a feeling of federation to bloom. But that does not preclude that one can hold
such a view as a worthy goal worthy of one working toward approaching; all this
while knowing that complete achievement, if not impossible, is very difficult.
With this general sense or goal, to meaningfully influence
a polity, those who seek it have several areas to address but none more
important than how citizens interact.
This is a wide field of human behavior and bits of information
concerning it can be found in analyzing many sorts of interactions between and
among a nation’s populous – both within the citizenry and among the nation’s
resident population.
One area where such information can be “culled” would be how
people behave in challenging settings such as when they interact with their
doctors. Ostensibly, that relationship
can and should be a cooperative one. Tort
law recognizes that relationship as doctors having legal responsibilities
toward their patients and some call this relationship an example of a fiduciary
duty.
And,
to wit, there is a great deal of case law in which the main topic is either alleged
or proven are in cases of negligence charged against doctors. One can judge such incidences – as these tort
cases – as falling woefully short of the ideal stated above in which federated
relationships are formed.
In this area, the writer, Malcolm Gladwell,[1] shares interesting and relevant
information. On the surface, this blogger assumed that a lawsuit involving
medical practice reflects poor doctoring or, at least, that a patient perceives
that poor doctoring occurred in his/her treatment. Gladwell disabuses his readers of such a
notion in its purer version.
It turns out that malpractice is not the main factor in
determining whether a lawsuit results from a treatment. As a matter of fact, poor treatment has
little to do with it. And that fact is
what makes this insight relevant to the concern of this posting; i.e., how a
people advance toward being federated.
Bottom line, it turns out, it is those doctors who are ranked as highly
skilled who are more apt to be sued than lower skilled ones. Actually, many, if not most, poor physicians never
see the inside of a courtroom as a defendant in a tort action.
Yes, a patient who goes to court feels or actually has
suffered poor medical service which has resulted in harm, but, as Gladwell
claims, something else is involved. And
that something has to do with the personal interaction between a doctor and
his/her patient. Citing the work of
Wendy Levinson, one can find that how a patient and doctor speak to each other
is a better predictor of whether such servicing will lead to legal action than
the doctoring that has taken place.
For example, according to Levinson, on average, “un-sued”
doctors – in this case surgeons – would talk to their patients for three more
minutes than surgeons who got sued. That
difference is reported as being 18.3 minutes as opposed to 15 minutes. But what seems more important is the tenor of
the conversations.
Psychologist Nalini
Ambady listened to the tapes of conversations produced by Levinson and with
sophisticated analysis, judged whether the conversations could be seen as
having “warmth, hostility, dominance, and anxiousness …”[2] That psychologist concluded, from the
analysis she conducted of the taped conversations, that she could accurately determine
which surgeons were going to be sued and which were not. Who were the unfortunate ones?
They were the surgeons that, surprisingly, sounded dominant. One tends, this blogger believes, to
associate dominance with expertise, something, one suspects, is a good thing
when it comes to surgery. But it turns
out that more important is a tone of concern that a surgeon projects. In turn, a patient reads certain qualities into
how the surgeon converses. Most
important – more important than expertise – is respect and caring which is
communicated by the softer tone.
When
things go bad, it seems patients are more apt to hold back on legal action if they
feel the medical treatment was conducted with respect and this blogger feels
that says something in how people get to feel federated with other people. If one is apt to place such importance on
respect and perceived caring in terms of medical services – getting operated no
less – then how important is it in everyday interactions? The obvious answer is very.
Gladwell
writes: “It isn’t necessary, then, to
know much about how a surgeon operates in order to know his[/her] likelihood to
being sued. What you need to know is the
relationship between that doctor and his patients.”[3] One can paraphrase this conclusion to make a
broader point. It isn’t necessary, then,
to know much about how a citizen reflects on his/her citizenry in order to know
his/her likelihood to being federated.
What one needs to know is the relationship among his/her fellow citizens. Is it based on caring and respect? If so, federation is possible.
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