Re: Queries: ROOT CAUSE

["Sandy Perle" <sandyfl@ix.netcom.com>]

> addressing only the surface cause will not prevent
> future accidents or incidents from happening in the same way. You need
> to address the underlying generic problem--radiophobia

Having studied TQM from the JUSE (Japanese Union of 
Scientists and Engineers) Counselors for approximately 4 years, I 
agree with Michael, basically. However, this issue, that of a 
physician either misusing his knowledge, or, just ignoring facts, or 
too damned stubborn in not receiving more definitive information 
prior to recommending an assinine prescription for his patient,  
can't be solved by addressing the public's general radiophobia. 

> Root causes always go back the the system, be it management,
> supervision, procedures, protocols, purchasing, etc. In this case, it is
> quite clear that the system is at fault for imbuing such fear, even in
> educated individuals. I would classify it as Inadequate Training, and
> the root cause of the inadequate training is the untoward fear of
> radiation, even in those who are providing the training.

IF it were the system, then there would be very few physicians out 
there making "correct", "appropriate" decisions. I think that to 
always blame the system for the failure of an individual, is a 
serious miscarriage of justice. Sometimes we have to hold the 
individual accountable, and stop blaming society for the "world's 
ills." While in some cases, in a specific situation, management and 
training can always be cited as a Root Cause. But they are not always 
.. just most of the time. In this case, are there any statistical 
correlations demonstrating that the other physicians who were in this 
physician's graduating class .. also have the same beliefs, same 
radiophobia, etc.? I doubt that there can be any correlation 
validated. SO, can we blame inadequate training in this case? I say 
not.

>  And those who
> write and provide the training are directly influenced by the
> radiophobic groups that set the standards that are so low it is easy to
> scare everybody. It is not until that root cause is addressed that you
> will have any chance of providing adequate training and influencing
> decisions and behavior up the line.

Again, I suggest that this is a serious over-simplification. I 
believe that for the most part, physicians provide adequate and more 
often than not, valid decisions when it comes to issues as discussed 
in the original post. To blame all physicians lousy decisions based 
on training .. I think we're going to far.

------------------
Sandy Perle
Technical Director
ICN Dosimetry Division
Costa Mesa, CA 92626
Office: (800) 548-5100 x2306 
Fax:    (714) 668-3149
  
mailto:sandyfl@ix.netcom.com
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