Good, not dumb Published May 30, 2018 By Lt. Col. Heidi Clark 60th Medical Diagnostics and Therapeutics Squadron TRAVIS AIR FORCE BASE, Calif. – A favorite quote of mine is from “Space Balls,” the 1987 movie parody of “Star Wars.” In it, the villain Dark Helmet, says, “Now you see that evil will always triumph, because good is dumb.” “Good is dumb.” This is probably an oversimplification, but my observations have been that “good” is too often some version of “dumb.” Good is often exhausted by acts of compassion and caring, such that good may appear lazy. Good may even actually be lazy, believing that “it’s the thought that counts” and actual results don’t matter. Good can be trusting, to the point of being gullible. Good puts high value on good intentions, cheerfully forgetting how prone to failure we all are. Good often forgets that love is not about just kindness and compassion, but that love also entails correction and discipline. Good may confuse confrontation with fighting and behave with timidity. Good is therefore too often steam-rolled, intimidated, taken advantage of and made ineffective. In healthcare and specifically here at David Grant USAF Medical Center, we strive to be a high reliability organization and to make patient safety the top priority. A 2013 article entitled “High Reliability Health Care: Getting There from Here” by authors Chassin and Loeb, discusses how healthcare is failing miserably in these efforts. They cite a variety of barriers from workplace intimidation to complacency to poor communication and call for three major changes to be made: Leaders must commit fully to zero patient harm; every available behavioral tool must be leveraged to support zero harm and process improvements must be deployed to systematically create an environment that supports the safest patient care. It’s time for us to stop being gullible and, instead, ask clarifying questions. It’s time to not let compassion fatigue exhaust us into complacency. It’s time to look for meaningful results, not just good intentions. It’s time for good to stop being dumb—for the compassionate profession of healthcare to leverage every resource available in our pursuit of zero patient harm. We as leaders,(in medicine and elsewhere, motivate people to achieve success, to protect those who rely on us and to leverage all of the tools available to us—process improvement, change management, Ishikawa diagrams and pareto charts—toward safe, efficient operations. This means providing needed training and tools; ensuring people are resilient and protect themselves from compassion-fatigue; empowering people with the “why” behind changes and demands; mitigating forces that would derail efforts; and guiding people to prioritize appropriately, aligning energy with organizational goals. We should not just want to do the right thing, but to do the right thing in the right way. The goal is compassionate care that is safe, because it is founded upon the best processes possible. Care that is good and not dumb.