We are approaching the 48th anniversary of the death of Catherine Genovese. In March of 1964 young Catherine was on her way home from work when she would brutally beaten and murdered by an attacker in the Queens borough of New York City. Although murders happen everyday in New York they are not to be taken lightly. And in this particular case there is something staggering that was uncovered by the police investigation. It appears that on the night of the murder 38 law-abiding, respectable citizens of New York watched the killer stalk and stab Catherine on 3 separate attacks in clear view. However, despite this alarming site, not one witness called the police until after Catherine was dead. How could 38 people fail to act under these circumstances? In interviewing the witnesses the responses were pretty vague and pretty weak. There was one common thread; all of the witnesses thought that someone else was going to be first one to make the call. The factor of social proof trumped reason and caused young Catherine to die a brutal death. Robert Cialdini discusses this case in his book Influence–The Psychology of Persuasion. He describes this type of social proof as a case of pluralistic ignorance–when a group of individuals all make a false assumption based on the actions of the entire group. This same type of pluralistic ignorance also exist in the healthcare staffing world. The principle of pluralistic ignorance operates most powerfully when people are observing the behavior of other people just like themselves. Many medical practices do not have enough experience to know what are the best business decisions to make when it comes to staffing. And so they end doing what the practice down the street does. If the practice down the street decides to cease operations while the solo physician is on vacation then they feel this must be the thing to do. If the practice around the corner doesn’t use locum tenens then they don’t want to be the first practice in town to use temporary provider services. None of these decisions are made on factual data or even use business rational. The results can equal patients that can’t see their provider while he away from the practice, irratated patients that can’t get an appointment with their provider during peak seasons, and loss of revenue. The lesson here is pretty clear. Although a locum tenen provider might not make the most sense in every provider coverage gap, the decision to use locums should be based on patient satisfaction and financial matters. Because the other local practice in the area might not be making their decisions on patient satisfaction or financial matters. Evaluate patient volume and forecast how much revenue a temporary provider could generate. Then compare these numbers to not having a provider at all. Practice managers will probably realize that what is good for the goose is not always good for the gander.

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