Whatever Happened to Thinking?

Ruth Linné Lander, FACMPE
Practice Administrator
Columbus Oncology & Hematology Associates, OH

Drawing closer to the end of my professional career, I have watched the world change dramatically with the onset of the space age, computers, calculators, and much more. But after watching all of these changes for decades, I don’t believe that all of them have given us the best results, for the average human brain, with respect to thinking.

Especially when I look at some of the younger medical professionals, I often find myself asking, “Can’t we expect more?”

So what is “thinking” anyway? The dictionary defines it as “using thought or rational judgment, intelligent.” Synonyms for thinking include reflecting, reasoning, discerning, pondering, and deliberating. I believe that our ability to plan and to think has been severely “numbed” over the past several decades growing up in the typical modern household and school system. At home, we often have many electronic devices at our fingertips, from televisions to smartphones. At school, we commonly have laptops, tablets, calculators, and other electronic learning devices in the classrooms. We can now take college classes and get certifications or degrees online without ever leaving our homes. As adults, our TV shows are often dumbed down and unrealistic to actual living, where real thinking is helpful. Our software can be amazing, doing more and more of the grunt work or processing, but it can also have the effect of a drug lulling the brain to sleep. So much is now automatic—just push a button. Look at the writing legibility and spelling of many young people today when they are not on an electronic device to see that problem surface.

I can recall energized math classes in the New York City schools that I attended from sixth grade through high school where we calculated math problems quickly on paper or in our heads. We learned to estimate the value of long lists of numbers quickly in our heads and really learned to understand what we should expect as a near result. Multiplying 10 by 100 doesn’t give you 100, it gives you 1000, and this was understood. When calculators started being accepted in classrooms, understanding what to expect went to sleep for many.

Several years ago a college student buying a $1.25 greeting card with a $10 bill seriously exclaimed to me, “Oh, do I get change?” In the medical field, getting the correct clinical information and calculating any treatment correctly can literally have “life or death” consequences, and therefore many automated safeguards have been put in place so that errors are minimized. But I have seen well-credentialed medical staff miss mistakes on the units of expensive drugs for billing purposes. Hitting the wrong key on the calculator or computer keyboard can result in a 10 instead of a 100, and not be seen as an absurd or unrealistic answer. Any “thinking” about what the probable result could be is missing. If the mistake isn’t caught, thousands of dollars go unbilled, bringing the clinic closer to insolvency at a very tough time. For the administrative side of medical practice management, it can have less immediately dire consequences and go unnoticed for a while but, over time, it can bring a really bad outcome.

I can remember an advertising class I took once where, paraphrased, the professor mentioned that 85% of people are just waiting to be told what to do, 12% think a little bit, and only 3% think things through thoroughly when presented with a choice or decision. I remember wondering if people really had been trained like Pavlov’s dogs into this robot-like response 85% of the time. I thought this was a pretty damning overstatement, but I have seen its validity over and over as the years have passed. Medical staff professionals often expect others to do all of the planning and process thinking from day to day, and just wait to be told what to do instead of looking at things in their area for that day or future days and making plans to make it work well with thought and flexibility—in other words, “thinking.”

I do see pockets of hope in some homes and schools. I see the thinking that students acquire when learning something like a musical instrument, gymnastics, or other activity or sport that is not automatic as they grow up. But, many times, we get people in our medical workforce who have never learned how to really think. At this point, we can’t be afraid to bring them back into the classrooms and become their teachers; this time for “thinking” classes. This is a daunting task with adults, but one that will benefit their practices while they are working, and the “students” for the rest of their lives.

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