"Protocols are for nurses."

Every now and then you hear something so dramatically stupid that you have to wonder.

One such example was a couple years back, when someone said: "I only text on the highway."

The latest example comes from a resident who was being "trained" by an attending doctor.  The resident was about to administer a drug using the protocol developed by that hospital's clinical department--one based on evidence produced as a result of systematic clinical evaluations.

The attending doctor interrupted the trainee and said, "Don't do it that way. I've been a doing this for over 20 years, and that way is stupid."

The resident replied, "But I've been told that this is the protocol."

The rejoinder, "Protocols are for nurses. Do it the way I say."

Which is worse, the pedagogy that has been employed or the practice of medicine that is being carried out?

After several years of participating in resident quality and safety workshops, I can report that we hear stories about this kind of thing quite often. Each time, the resident is put in an untenable position. Each time, a patient is put in jeopardy.

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