A spade by any other name

Issue: BCMJ, vol. 53, No. 8, November 2011, Page 452 Editorials

I’m afraid I’m not a very good Canadian. I don’t eat much back bacon, seldom wear a toque and don’t really like the way our great late novelist, Robertson Davies, writes. He uses a fifty dollar word when a five cent word would suffice.

Over the last few years, I have been forced to attend a number of meetings chaired by administrators of my local health region. Since I don’t want to single any one group out I will disguise their identity by referring to them simply as FH (I live in the Fraser Valley). The problem? I often have no idea what they are talking about. They use all these words and sentences that leave me completely lost. 

I have a university degree, and apart from my friend Robertson I like to read and usually can follow along without a dictionary. Therefore, I went to FH’s website for guidance. Perhaps the executive is made up of brilliant, Nobel Prize–winning wordsmiths? Maybe their bios would bring more clarity. 

To paraphrase a few, one vice president “has a mandate to create great workplaces through innovative, sustainable, and results-oriented stra­tegies that engage leaders and team members in organization transformation.” Another vice president “provides executive leadership and strategic oversight to a range of integrated community programs designed to improve health system capacity and foster a population health focus that will help sustain care and services across our rapidly growing communities.” Anyone else confused?

I began to think that perhaps like medicine, the corporate world has a unique language. To explore my theory I visited the websites of many top corporations—banks, investment firms, and communication companies to name just a few. Interestingly, their executive titles read like this: “vice president of human resources,” “vice president of technology,” “vice president of finance,” and so on. The bios were clear and concise and left no room for confusion about what the individual was responsible for.

So why are health administrations filled with such confusing language? It seems to be a systemic problem as I have checked other health regions and even other provinces. Maybe if it isn’t clear what you do then you can’t be evaluated? How exactly does one determine if an individual has been successful at “creating great workplaces through innovative, sustainable, and results-oriented strategies”? What does this even mean? 

Throughout history certain groups set themselves apart by having a secret language, thereby keeping the populace at a disadvantage. I suspect that the private corporate world is simpler because if it isn’t clear what you do they know they don’t need you.

How about we call a spade a spade. I fear that potentially good people are being weeded out as they refuse to learn the language and play the ad­vancement game. The survivors run entire meetings where nothing is said and nothing is accomplished. 

Pre­viously we had fewer administrators who were very approachable. If you asked a question you got an answer. Good ideas didn’t have to go up through all sorts of committees and face “adjacencies, paradigm shifts, or operational matrixes.” How about we get back to making timely, commonsense decisions that im­prove the health and welfare of our patients?

In the meantime, I have an opportunity to innovate strategically and align my operational needs thereby sustaining my changing and challenging environment. In short—I am going grocery shopping. 

David R. Richardson, MD. A spade by any other name. BCMJ, Vol. 53, No. 8, November, 2011, Page(s) 452 - Editorials.

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