Mourning for Teachers Across Education and Health Care

My heart is heaviest when my family members are treated poorly, especially by those who are supposed to support them. As a nation we should have heavy hearts for teachers, nurses, physicians, and others prevented from teaching by the basic designs of our nation.

Hopefully the school in question will come to its senses and support my remaining family members who are still teachers. There are few left as most have been driven away from teaching by a combination of chronic poor support, lack of backup, and acute events that resulted in departure. Our family, your family, and students lose by design. Schools and school districts must support teachers. During this time period near the end of the school year, it is critically important to support teachers.

It is a time when many teachers and their family members wonder whether it is worth it for all the additional efforts that are not supported, including the efforts that can make a difference in the lives of students.

As a primary care physician I have long asked this question, and the result has been a departure from primary care. I still think about my patients across decades of primary care, but I do not miss the constant strain of do more, for less, plus please go the extra mile, hours, efforts, committees, special projects...

A previous blog addressed the same more, more, more, more for less demanded of nurses and physicians. Why Prevent Doctors and Nurses from Teaching and Nourishing? Some of these points are summarized.

Why have health care designs taken doctors and nurses out of their original designs?

Why have education designs taken teachers out of their original designs?

Why do we measure so much when there are not resources and supports to address areas found lacking in measurements? Why is so much spent upon measurement that there is little left to support the team members to teach?

Why do we expect more from teachers, nurses, and doctors in health and education when we continue to neglect children, child well being, and the determinants of health and education shaped from the earliest months and years of life?

All who work on the front lines interfacing with students and patients and citizens have faced troubling times. Police, nurses, physicians, and teachers face more difficult times when those they work with do not have future focus. Widening disparities leave more behind. Challenges increase with housing, health care, food, and other costs too high and getting more costly.

Payment too little in areas such as primary care, mental health, and basic services has clearly compromised
  • time with patients, 
  • teaching, and 
  • support of team members to teach and interact with the community
Designers out of touch with the primary functions of workforce have not helped. The designers across human infrastructure have failed - for decades of designs.

Compromises of Teaching and Learning

Our designs hardly give teachers time to teach so perhaps the real problem is about our nation and its approaches to teaching and learning. This impacts children from the earliest ages leaving most behind. Earliest impacts also damage the exclusive in areas that they least understand - and impact our nation in designs for health, education, economics, and politics.

The real crisis in education is an Open Letter from a Teacher to the incoming Secretary of Education. This gives just a glimpse with regard to measurement, test focus, and other impediments in teaching and learning by design.

The Lessons of Exclusive Origins, Exclusive Designers, and Exclusive Designs

Today in Upshot in the New York Times the level of eliteness in the elite colleges was illustrated in graphics. The graphics reveal that the top 1% supplies more students than the bottom 60%.

Most of the time, this is used to illustrate lack of diversity. But few seem to see the most major problem - the lack of awareness. Those born, raised, educated, and trained exclusively have very little chance to understand the real world or most people quite different from them.

Two movies come to mind. In Overboard, Goldie Hawn was given the chance to understand what it was like in poor working class situations after a life of luxury. From her personal servant played by Roddy McDowell - "But you madam, have had the... rare privilege of escaping your bonds for just a spell. ... How you choose to use that information is entirely up to you."

In Father Goose, Cary Grant's character was a history teacher that gave up on the exclusive children that failed to learn from history and were repeating the same mistakes - as seen in World War II. 

Cary Grant dropped out into the South Pacific to major in scrounging and alcohol. He has been forced to become a coast watcher to identify Japanese plane and ship movements. Leslie Caron plays a school mistress in charge of children. They have been stuck on an island together and she has been bitten by a snake – or rather a stick that looked like a snake. They both think that she is dying and they are being totally transparent, with the help of the alcohol used to kill her pain. She is referred to as Goody Two Shoes and Cary Grant is the Filthy Beast.

Goody Two Shoes/LC - What was she like


Filthy Beast/CG - She who



LC - The lady that drove you to … drink

CG - That was no lady

LC - That was your wife – (cackles)

CG - No, No, There was no wife



LC - From what are you running away from, hmm?

CG - Oh I’m not running away

LC - There must have been some…some…

CG - There was, it was a necktie.



LC - A what?

CG - A necktie. I was late for class one morning. I forgot my tie and they wouldn’t let me in.

LC - How long ago was that?

CG - About eight years ago (1933)

LC - Weren’t you a little old to be going to school?

CG - Oh, I wasn’t going (looks around to see if the children are listening)

Ahem… I was teaching. I was a professor of history. (shrinks down)

LC - And what about the necktie.

CG - This is no time to talk about me.

LC - Why not?



CG - (Sighs) Why not?- Well, see, I thought they would be more interested in what was inside of a man’s head than what was around his neck. Then, I noticed that they all wore ties. They all looked alike. They all behaved alike. They all talked alike. They were all going the same way, no matter which way they said they were going. So what was the use of teaching them history, or anything? They weren’t learning by it. They were still creating the same world (or old) problems. So I packed, got on a boat, and got away from them.

Now Look what they got me doing



LC - (Giggles uncontrollably) You - a schoolteacher.

(Sits up, gasps) Oh dear (she collapses and seems dead, he pulls up cover over her head, takes a belt)



Watch Father Goose from 1964 for the revival, marriage, and escape. This movie took the Oscar for Best Screenplay and those winning credited Cary Grant for winning a number of Oscars - for everyone else.

Recent actors deserve some credit for indicating that movies are just movies, but there are lessons to be learned from history. In the original blog I reviewed the lines given by Cary Grant as Father Goose - a character that realized the hypocrisy of teaching exclusive students who failed to learn and replicated past mistakes when they led nations. Why Prevent Doctors and Nurses from Teaching and Nourishing?

I have been thinking about Robin Williams much lately and the roles in Good Will Hunting, Awakenings, Good Morning Vietnam, and others. In Dead Poets he was teaching the students to explore and reflect and consider. Those most exclusive appear to need different awareness and understanding. 

We need to get away from creating the same world problems and learn from our mistakes. The quality gurus understood the need for the outside perspective. Since this perspective involves well over half of the nation's population, leaders in health, education, economics, and politics better learn to listen.


Recent Blogs 

Why Prevent Doctors and Nurses from Teaching and Nourishing?

Office Visits Do Not Break the Bank But Insurers Can

Necessary Rather than Disruptive Transformations

Ending the Disruption of Pay for Performance and Payment Plans that Lack Evidence Basis and Discriminate

Best of Basic Health Access Blogs

Do Family Medicine Leaders Deserve the Trust of the Students Choosing FM?

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Does Academia Compromise Health Care for Most Americans?

The 25th Anniversary of the COGME Third Report and No Change By Design

Why Is Value So Hard to Recognize in Health Care and why does family medicine not value family physicians and the high value places where they practice

The Four Horsemen of the Primary Care Apocalypse - Medicaid, High Deductible, Veteran, and Medicare Plans shape failure by payment design

Plea to Academic Leaders - Please No More So Called Primary Care Solutions - No Training Intervention or Practice Rearrangement Can Work without Payment Reform

What Is Stunning in Primary Care Is No Change By Design - Numerous failed attempts to recover primary care all point to insufficient payment made worse by accelerating cost of care. 




Robert C. Bowman, M.D.        Robert.Bowman@DignityHealth.org

The blogs represent the opinion of the blogger alone.


Copyright 2017

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