Resistance to Change

Abstract

Advances in medical technology do not follow a smooth process and are highly variable. Implementation can occasionally be rapid, but often faces varying degrees of resistance resulting at the very least in delayed implementation. Using qualitative comparative analysis, we have evaluated numerous technological advances from the perspective of how they were introduced, implemented, and opposed. Resistance varies from benign -often happening because of inertia or lack of resources to more active forms, including outright opposition using both appropriate and inappropriate methods to resist/delay changes in care. Today, even public health has become politicized, having nothing to do with the underlying science, but having catastrophic results. Two other corroding influences are marketing pressure from the private sector and vested interests in favor of one outcome or another. This also applies to governmental agencies. There are a number of ways in which papers have been buried including putting the thumb on the scale where reviewers can sabotage new ideas. Unless we learn to harness new technologies earlier in their life course and understand how to maneuver around the pillars of obstruction to their implementation, we will not be able to provide medical care at the forefront of technological capabilities.

Evolving Frameworks for the Foundation and Practice of Electronic Fetal Monitoring

“…Furthermore, liability exposure concerns over using or not using new approaches can be a significant factor in the adoption of new approaches. 6 Such liability exposure also various enormously around the globe.…”

“…In general, the incorporation of new medical technologies has occurred at a slower pace than has been the case for new technologies in many other industries. 6,7 The culture of medicine, while desperately seeking new approaches to managing critical problems, has also been notoriously resistant to major changesoften, in some countries because of fear of liability exposure. 6,7 The timing of adoption of new technologies often varies in practice with some physicians/institutions/countries being "early adopters" and concludes with groups of "late adopters."…”

“…6,7 The culture of medicine, while desperately seeking new approaches to managing critical problems, has also been notoriously resistant to major changesoften, in some countries because of fear of liability exposure. 6,7 The timing of adoption of new technologies often varies in practice with some physicians/institutions/countries being "early adopters" and concludes with groups of "late adopters." There are many components involved in the variable timing of technology adoption that include technological capabilities, resources available to bring in new technologies, the cost/benefits of such developments, return on investment, the personalities and training of practitioners for being open to new ideas, and perceived liability reductions and exposures when considering new technologies.…”

“…There are many components involved in the variable timing of technology adoption that include technological capabilities, resources available to bring in new technologies, the cost/benefits of such developments, return on investment, the personalities and training of practitioners for being open to new ideas, and perceived liability reductions and exposures when considering new technologies. 1,5 Overall, a change from one technology to its replacement has two requirements: First, the new technology seems ready, and second is an improvement over the existing one; [5][6][7] the providers become uncomfortable with continuing to use the old approach. With few exceptions, there is never a universal agreement that a new technology should immediately replace the old onejust as there is not usually universal acceptance that a new management paradigm should replace an older one.…”

Rh Sensitization and Induced Abortion

“…In summary, we believe that far more study is necessary before abandoning established practice that may still be effective in reducing HDFN risk. Incorporating new concepts and procedures into medical practice is hard; it is harder to get old ones out …”