Navigating Change

Many people were dedicated students of [Ernest Holmes] philosophy, actively supporting his teaching. They began urging him to set up an organization and incorporate.

Ernest Holmes resisted initially, feeling that an organization would be restrictive. He insisted on the necessity of individual spiritual freedom, saying that Infinite Truth was not the exclusive property of any special group of people, and that his teaching was not a “final revelation”.

SOM Archives
Ernest Holmes

I taught for many years in a professional health care program that culminated in new graduates sitting for a credentialing exam – medical records administration – which in the late 1990s changed its name to Health Information Management.

In decades prior, these credentials were required if one wanted to work in the field of medical records management.

I still hold these credentials and work in a traditional medical records environment, but I am the anomaly. I returned to this environment recently after spending most of my career in non-traditional roles and find my experience to be useful as the profession faces significant change. As someone who is not rooted in “the way it’s always been” I am able to lead the (many) changes that are occurring in my department and profession.

There is unrest in the HIM profession right now because the credentials that were once REQUIRED are no longer given the deference they had in the past. The world has shifted from the days when paper pages filled cardboard folders, creating the record of medical care. Today the Electronic Health Record (EHR) has emerged with the rest of the technology revolution and changed healthcare and my profession.

These changes have had a significant impact on the credentialing organization. I taught at the baccalaureate and graduate level. When I left academia, the department chair had implemented a requirement that students sit for the credentialing exam to graduate, because so many students were finding jobs – GOOD jobs – without the credential and so few students wanted to pay the money and sit for the exam. For me, this was the first clue that the onward march of technology and time was exerting an impact on “the way it’s always been done” in my profession. More evidence on this would follow.

The Joint Commission (TJC) is the gold standard accreditation body that helps to hold health care organizations to high standards of care by providing oversight and evaluation of their policies, practices and more. In previous years, when TJC site visitors showed up, a call was made was to the Director of Medical Records/HIM. One reason was that the number of unsigned charts was historically a significant review activity.

In recent years, HIM Directors are not only missing from the first-call list, but sometimes never make contact with the visitors. One reason is the Electronic Health Record which makes it next to impossible to “hide” unsigned medical documentation. Instead of needing to go through the HIM Director to see if a random sample of charts are signed, anyone with login credentials can generate a report of all the unsigned records at the click of a button.

Change can come in an instant

I believe another reason is that accreditation agencies have ranked patient safety as a more important metric to monitor than unsigned notes (and I agree). With limited resources and a need to focus on the biggest bang for the buck, a decision was made to remove the accreditation requirement for “delinquent records” (those that are missing or unsigned) from their checklist.

And just like that – the role of the HIM/Medical Records Director changed.

Seemingly overnight (it wasn’t), the selling points for earning and maintaining a credential in the HIM field have evaporated along with the traditional medical records department in many facilities. Rooms with multiple moving shelves of paper records have been replaced by servers and the cloud.

In Pittsburgh, one large health system which is comprised of more than 20 hospitals in the greater Pittsburgh region, closed all the HIM departments in their facilities and now manages their HIM operations from a single, central location filled with computers in the heart of their flagship location.

Why am I writing about this on a spiritually-themed blog?

Because it is an example of the impact of technology and shifting norms that are inevitable as time moves on. And because I see the same “camps” in my spiritual community that I have seen in my professional sphere:

  • those that are clinging tightly to “the way it’s always been” and hoping against all hope that this storm is going to pass and everything will return to the way things used to be;
  • those that feel the shifting winds and want to use what they have learned and apply it in the new paradigms that are emerging.

In the HIM field, there are MANY ways to apply the foundational education that is provided in the best programs. The graduates that I and others have taught are proof positive that this is the case, as they are a who’s who of successful, professional individuals working in the healthcare industry. They do not manage medical records departments; but the skills they learned in college opened doors into careers that will sustain them as long as they choose.

I recently heard someone in my larger spiritual sphere talk about the need for loyalty to the main organization that credentials religious science Practitioners, and I had a deja vu experience.

Ten years ago I was hearing this same verbiage from a department chair (and others in the credentialing organization). Did their mandatory requirement that all graduating students take their credentialing exam and remain loyal to the organization result in more credentialed HIM professionals?

Short term, yes. Students did what they had to do to graduate. But at the end of that 1st year when the renewal notices came in the mail, very few renewed their credentials.

Was it because they were angry at being forced to do it in the first place?

No – it was because the credential was irrelevant for them, and had nothing to do with what they were contributing in the workforce and the world. And this trend is continuing downward as new college programs that teach the foundational concepts are emerging without an affiliation with the credentialing organization (which means more people than me are seeing this trend and acting on it).

There’s a lesson here that echoes the cautions of Ernest Holmes in the last century. He insisted that “Infinite Truth was not the exclusive property of any special group of people”. He was also stern in his push back against those eager at the time to create a formal organization:

As the organization took form, however, Ernest made it clear that the founding of the Institute was not intended to promote Religious Science as a cure-all religion. He would not allow anyone to regard the Science of Mind message as infallible. “Religious Science is shorn of dogmatism, freed from superstition, and open at the top for greater illumination, unbound and free,” Ernest said.

SOM archives

Unbound and free.

Open at the top for greater illumination.

Ernest Holmes would have encouraged students of the Truth principles that he taught to explore the world; to engage with other philosophies and test the veracity of the SOM postulates. He would have encouraged collaboration, exploration and the integration of other streams of spirituality in the consideration of the principles he put to pen and paper.

There’s nothing unbound and free in “you must remain loyal to this organization“.

There’s no greater illumination possible if it’s “this is the company line that you adhere to, …or else” (especially in the “or else” – implied or explicit).

The definition of the dogma Holmes specifically warned against is evident when the hierarchy begins to marginalize and speak negatively about those who wander off the prescribed path and speak the Truth through their own, perhaps slightly different, lens.

Truth principles hold that “there is enough for everyone“. Insisting on loyalty to an organization “or else” is a lack mentality, and had no place in Ernest Holmes’ emerging philosophy and has no place in the New Thought of the 21st century.

We are better than this. And I look forward to seeing that better side expand beyond the fear and lack that I have heard too much of over the past few years. And so it is.

(C) 2019 Practitioner's Path

One thought on “Navigating Change

  1. Pingback: Healing – A Dangerous Business | A Practitioner's Path

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