Unique Missionaries in Medicine

During a break in an instructor class, a salty, well seasoned medic from the night-shift streets of Denver told me he was my disciple. 

BDT4EMS_instructor_shirtefore I get to far, let me take you back to a class I taught in Denver back in 2010. This class was filled with seasoned EMS providers from the busy streets of Denver. Toward the end of the instructor course, one of the potential new instructors, (a salty, long-time night shift medic) caught me off-guard when he said “Kip, I am your disciple.”  I was taken back a tad because I wasn’t sure what he meant.  His meaning became clear when he stated he understood how he and the others (new instructors) would face ridicule and shunning from other experienced providers when they attempt to expose the truth. He told me he realized this because of the change he himself had just experienced.  Rather than a disciple, I feel he and other DT4EMS Instructors are in fact missionaries in medicine instead.  This blog post will explain what I mean.

One definition of a missionary is: a person strongly in favor of a program, set of principles, etc., who attempts to persuade or convert others. (1)

 Nurses, Firefighters, Paramedics and EMTs who chose to become an instructor with DT4EMS came to us with an open mind.  Although they were previously indoctrinated in the culture of provider/patient interaction, they still believed something could be done to make patients and providers safer during the interaction of a patient/provider relationship.  Even open-minded providers have some form of a defensive wall built due to years exposed to the culture as it currently exists in emergency medicine.

A large part of our program is removing the rusty and jaded perceptions from experienced providers. Having the opportunity to witness culture change, although timing is not the same for everyone, one can readily recognize when the defensive wall begins to chip away and the original caring provider is revealed.  

 Once they see truth in all its glory, having been changed themselves, they leave our 40-hour course on fire. They are willing to take lig2015-08-08 19.28.54ht into the darkness, knowing they will face ridicule, avoidance by peers, and have staff who don’t want anything  to do with the message of culture change… just like a missionary.

 The new DT4EMS Instructors willingly go back into a shark tank, hornet’s nest, lion’s den or whatever you want to call their agency/peers, and attempt to show them there is a better, safer and more reasonable way to handle conflict on the job in emergency medicine than the standard of “do whatever it takes to go home.”

Often  times DT4EMS instructors find themselves in hostile situations inside the classroom. Rarely are the people they present to physically aggressive, but many are certainly postured defensively, verbally antagonistic with arms folded having a “prove it” attitude. To make matters worse, sometimes while the subject of violence on the job was a hot button topic due to an assault on a peer (The recognized assault is what had their agency send them to become an instructor) the new instructor completes our stressful program, prepared to help change the culture (like a missionary) only to return to their agency and violence is no longer considered an issue by their administration(even though it is THE leading cause of lost work time in medicine).  

For those who actually get to share the message, after the first 4 hours of a class they present… The minds of those in denial begin to see there is truth in the message. The participants start to go from leaning back in their seats with arms folded, into a forward leaning posture, arms open ( sometimes even dropped jaw) as they say “I had no idea” and “where has this training been?”

 Our DT4EMS Instructors (missionaries) have already personally realized once the defensive wall of false culture is broken, the real and lasting culture change can begin. Therefore, they are even more excited to see their peers “get it” than when they first realized the truth themselves. 

The DT4EMS Instructor, having seen the error of their personal work culture, their behaviors, and perceptions has a desire to help others see how much better work/life can be when a culture is changed. They are simply trying to be a helper, just like the reason they joined emergency medicine in the first place, just on a different level.

Perform your due diligence.  Don’t just take my word for it. Violence in healthcare and the need for actual culture change are problems of epidemic proportions. Research the problems, validate your research, and I am sure you too, will become a missionary in medicine.


1) http://dictionary.reference.com/browse/missionary accessed 8/19/2015

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