While living in a foreign land I was tasked with bringing a technical presence into the five hospitals in the city where I lived. Students were selected, equipment was being repaired, and preventive maintenance, a new concept, was introduced and service support was growing in an area of the country with no BMETS in sight for hundreds of miles in any direction. Things were getting better and the outlook regarding establishing a biomed presence was promising. After a year, all of the sterilizers in the city were functioning correctly thereby greatly reducing post- operative infections and increasing the odds of survival for the patient.

One evening there was a knock on my door and a man whom I did not know warned me in broken English that the White Mafia did not like me. A short time after that encounter, a doctor came into my office. I knew the doctor and approached to greet him. While standing at my side he put a 38 revolver in my side at about heart-level. I knew if the trigger was pulled I could not survive. I asked him, “Why?” The doctor responded, “I hate your heart.” I was able to take the pistol from the doctor, removed all the bullets, gave him his weapon and asked him, “Please not do that again.” The doctor smiled and walked out of the office. After he left, my knees gave out and I began to shake.
I was introduced to the White Mafia, otherwise known as medical professionals. (This term, Mafia, does not imply a crime ring, but is simply a local name given anyone wearing white lab coats). They were angry because the presence of technical support meant less sales of medical equipment. It seems that some doctors had a vested interest in new devices. Some doctors and politicians, (who were also doctors), owned companies which sold medical equipment. The dramatic reduction of post-operative infections also impacted pharmacies often owned by doctors as well.

In my zeal to introduce a technical presence as fast as possible, I did not consider the culture in which positive change was being introduced. Though the idea of introducing BMETS and CEs into a remote area was highly popular, drawing the attention of the media, politicians and businessmen; consideration was not given to the doctors and their associates regarding any negative impact upon their local economies. I began then to involve those who were impacted and eventually the introduction of a technical presence in the third world became a team event from an alliance with the White Mafia. Had I known I would have, could have, and should have first sought to partner with all parties who were willing to lend this American a hand in helping their people.

Herein lies the point I wish to make; we in the Clinical Engineering/Biomedical Service field are specialists in what we do. We know our skills and the benefit we bring to the hospital/account. But do we consider the “culture” of the hospital? Do we seek alliances with each department and understand their concept of our service support? Does the client resent and resist us because we are so intent upon servicing devices that we ram our service down their throat like moms forced their children in the 60’s to take castor oil because it was “good” for them. Is our technical presence truly a help or are we seen as invaders?

What is your take on this? What is your experience?

Do tell!