John Hardie and Adele Yamada

Health care authorities and experts have a lifelong influence on future generations of health care professionals and medical scientists. Commonly, those teachers are paternalistic and even autocratic figures who, with their credentials and egotistical attitudes, communicate personal opinions and experiences to students via lectures, laboratory exercises, clinical rounds, and examinations. This transfer of knowledge is often accomplished in a mystical aura of esotericism and idolization pervaded by covert and sometimes overt intimidation. It is, especially in clinical disciplines, a closed system which stifles debate and constructive criticism from students deemed by their status to lack the intellectual capabilities of those in command. Stagnating due to an absence of fresh knowledge or creative input, this hierarchical system produces graduates and the next generation of potential experts who perpetuate the attitudes, behaviors, biases, and skills of their teachers. In turn, this closed rigid system creates a dogmatic – even arrogant – approach to the delivery of health care, which leads to the entrenchment of the status quo. In such an unyielding environment, it should be no surprise that the dissenting voices of Semmelweis, Marshall and Warren were not only ignored but ridiculed for their seemingly misinformed opinions.

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