A person suffering with a terrible, chronic medical condition receives an unproven treatment from a young doctor. The treatment results in the patient’s recovery. Soon after the accolades die down, the doctor is accused of violating policies, her career is subsequently ended very publicly. The effective treatment is never again used in that organization, and doctors all over the country were reluctant to try it. How might SCRAP have contributed to this turn of events?
This is a really complex scenario and I don’t know where to start with your SCRAP question.
I have more questions than answers but I’d love to chat about it but not in a text thread.
Maybe you can start by answering this first question here in the thread:
Which turn of events are you referring to in your SCRAP contribution question. (I see at least 4 turn of events in the scenario…)
You’re right- it is complex. I dumped a number of very different stories in here but it is probably too soon to go so wide. This one is pretty wide, and we should probably focus a bit more for now.
To close this situation out for now, I was thinking of a particular part of it: The hospital’s policy that the doctor violated. From the perspective of the doctor, patient, and others this Rule prevents the hospital from providing the “best possible care” - which he proved he did when he saved the life of this patient using the experimental treatment.
So if we were to examine whether this Rule was SCRAP we would quickly find that it exists for very good reasons - to prevent malpractice, use proven practice to better ensure patient health etc. etc. etc. So we would say that the rule is clearly not SCRAP. The doctor might also ask “why does it have to be ME or THIS hospital to do the experimental thing?” Or “Are my values and purpose realized in this hospital or should I consider a different kind of practice?”.
However, what is also clear is that the hospital is not purely about patient health, period - it is about patient health insofar as that can be achieved with proven/established practice. And that might be perfectly fine and acceptable. Or we might want to find ways to handle such terminal situations that don’t put the hospital at risk.
So looking into SCRAP situations helps the org continue to re-examine itself based on real tension, and the people to understand the “why” behind things, make better decisions, and champion improvement.