The April Fast Company has a nice short piece that talks about medical teams receiving “crew resource management” training based on safety lesions from the aviation industry. It’s about how to perform under pressure as a team. Here’s my favorite quote:

And if there’s a problem, even the team’s most junior members are trained to say something. That’s tricky, since it means confronting the medicine’s doctor-as-deity culture. “It’s sort of like giving permission to speak up…. Something as complicated as an OR procedure requires everyone being able to pick up on things that could lead to problems.”

Look carefully at the words: junior members trained to say something; permission to speak up. Isn’t it ridiculous that we need to train people or give them permission to speak? But of course, we all know that we do. In “normal” situations the junior person would never speak up. But giving them that freedom should be easy. And I don’t think it should require the presence of the life and death pressure of the operating room.