Staying on track

Driving change can be a lonely and intimidating process

There are times when it feels as if the world rejects you, your ideas and your mindset. It takes courage to carry on, but if you truly believe in what you are doing and are totally committed to seeing it through – you can make a difference, and the world will be a better place.

Every so often we stop, take stock, re-evaluate and second guess our instincts.

Then we realise that is just plain stupid and carry on…

As Niccolò Machiavelli said

“There is nothing more difficult to take in hand, more perilous to conduct, nor uncertain in its success,  than to take the lead in the introduction of a new order of things, for the innovator has for enemies all of those who have done well under the old, and lukewarm defenders in all of those who may do well under the new.”

…and as William Cadogan said (…just before he was kicked out of the Royal College of Physicians, London)

…If I have hazarded anything new, or contrary to received opinions, it has been from a thorough conviction of it’s truth, however dangerous to fame and fortune; both which I know are more easily acquired by complying with the world, than attempting to reform it: but it must be somebody equally indifferent to both, as I am, who will venture to tell such truths as are more likely to recoil and hurt the author, than to convince and conciliate the bulk of mankind.


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  1. says

    Dear Mike
    Could not agree more with your well written post. I’ve had many instances in my past where I encountered similar situations, but I chose to go against the norm (so to speak).
    Two examples:
    1.When I was in med school, could not wait to finish to get into basic research, when everyone thought I was plain crazy.
    2. After 10 years at ANU, left John Curtin School of Medical Research to work with a pattiserie making macarons, tarts, pastry- I still work there.
    Now I am waiting to sit Part 2 of the AMC exams but have been pushed back continually by the AMC. So I’ve decided to go across the ditch to attempt the exams in NZ.
    By the way, your imeducate helped me in prep for the MCQ part and could not thank you more.
    The saga continues, but I soldier on with the belief that my time will come and I’ll get to do good.
    Who knows, someday I might be your intern!!
    Thanks again.

  2. Thomas Plappert says

    Thanks for your lines. For ten years, I help to establish EM as a recognized speciality in Germany… and we, the hundreds of doctors basically practicing EM here everyday, seem to be crazy…

  3. says

    I couldn’t have read that at a more timely moment. I am trying to drive through a training program where I work. After an critical incident I identified a big hole in the training. I suggest ways in which it could be improved or even solved. Opposition was baffling. Despite multiple similar incidents, they just didnt see there was a problem. ‘We are fine, we don’t need the extra training.’ Trust me, we do. So I have set about conducting an audit which has proved there is a problem, created the justification for the training program, performed the literature search to provide the evidence for how it can be done and worked out a way it can be affordable and sustainable. I’m taking it all to the boss tomorrow.
    But it has been a lot of work. And it’s not over. It is still going to be me driving it through. But with the boss behind me, the rest of them just have to suck it up and get on with it. Hopefully then they will see the benefits and continue with it after Im gone.
    Thanks LITFL I needed that.

  4. says

    thanks for these lines.
    I feel great difficulties in blogging and social media for a long time (seems french people are not really interested in sharing medical information, just telling stories and complaining).
    I feel difficulties too in my new professionnal work, where very old habits stop all new good managements.
    I have to trust myself and keep the faith.

  5. Dr Rosemary Craig says

    Unfortunately the big problem with peer review medicine is that once there is something truely innovative and original then there are no peers. Evidence based medicine assumes the resources to produce sufficient proof and publish it, after peer review. I am a rural GP in Australia. My own GP would rather quote a poorly written devisive paper from the BMJ in the last decade than consider the evidence that electromagnetism could be used as a therapeutic tool.
    Who are the peers for the true innovators?

  6. Francesca Ambrosini says

    I appreciate and have faith you will continue the great work your brilliant Ancestor has set forward.