Organizations everywhere risk struggling with internal conflicts or resistance to change, lack of transparency, unclear identity and vision, self-serving or ego-driven decision-making, and flawed groupthink. These issues can steer societies away from their goals to provide benefits to their collectives and the communities they serve. Hence, they jeopardize the organization’s future and may irreversibly harm the organization’s reputation.
What applies to other organizations and society at large also applies to bronchology and interventional pulmonology (IP) associations around the world. The IP culture built around technical innovation, science, ethical practice, and unselfish assistance to patients everywhere has evolved favorably over time, but this has not been without facing many challenges.
To cite one example of overcoming internal resistance to change (there are many others), the culture dates from an era when forward-thinking, independent but often self-reliant practitioners were dismissively labeled as “cowboys” by colleagues who were less inclined toward new interventional approaches. For many years, a few leaders had to dedicate significant time and effort to demonstrate the safety and value of their procedures, and to survive academically within more conservative academic medical establishments. Using “show and tell” lectures and retrospective studies – prospective and randomized studies would come later – they proved that certain interventions significantly improved clinical outcomes, quality of life, and patient survival. Gradually, they overcame resistance from colleagues, skeptical referring physicians, other specialists wary of competition, hospital administrators, and members of pulmonary societies who were, at their worst, obstructionists.
Similar resistance was faced by those who challenged existing training methodologies. Significant energy was needed to move beyond the outdated apprenticeship model of medical education to more modern and complementary learner-centric and patient-friendly approaches. These include using inanimate models, simulation-based training, ongoing competency and skill assessments, checklists, faculty development programs, multidimensional curricula structured according to individualized needs assessments, a democratization of learning resources, and computer/instructor-assisted feedback methods. Today, it is universally accepted that patients must not suffer the burden of procedure-related training.
Whether in establishing the value of a technology-driven medico-surgical subspecialty or in championing a novel means for training its practitioners, history demonstrates that persistence and resilience in the face of opposition will ultimately yield rewards. Courageous and unselfish leadership may often go unnoticed, but the benefits gained by practitioners, students, and patients alike are substantial and often life-changing. Leaders who feel disenchanted by their colleagues’ apparent lack of enthusiasm should be inspired by these words from former U.S. President Ronald Reagan: “There is no limit to the amount of good you can do if you don’t care who gets the credit.”