White Wall of Silence
Denial isn't conscious
As early as the 1950's, the psychologist Solomon Asch did a series of laboratory experiments in which he put groups of people in rooms and asked them simple questions that any child could answer correctly, such as which of three lines drawn on a piece of paper was the longest. The answer is obvious, unless other people answer it incorrectly first. All of the people in the room were plants except one. The plants would agree on an incorrect answer. After witnessing that agreement, other people usually agreed with it too. Things that obviously could be seen to be wrong by an independent observer, were not seen as wrong because of the suggestion of others.
Three out of four people gave an incorrect answer to a simple question after overhearing others give that incorrect answer. Recent research (lead by Dr. Gregory Berns, a psychiatrist and neuroscientist at Emory University in Atlanta) using MRI's shows that they are not lying. They actually see solid, physical things differently based on what others have said. They do not believe their own eyes as much as they believe what the group says it believes.
Seeing is believing what the group believes
These studies were done with groups of strangers with little in common. Imagine how much more influence the false answers would have had if uttered by members of the same profession, for instance if all the subjects had been police officers. Imagine how much more influential it could have been if all the subjects were not just members of the same profession, but knew each other and worked with each other everyday, like members of a surgical team. Could there be a less sinister explanation for how James Burt was protected by all other healthcare workers, by the hospital, and even by the state medical board?
Self Confidence is Contagious
Dr. E. James Potchen at Michigan State University in East Lansing studied the accuracy with which certified radiologists studied x-rays. One of the most interesting things he found was that even those who were the worst at it were highly confident in the accuracy of their work.
This is one of the reasons that asking health care professionals to make medicine more transparent is ignorant. They don't see it when their colleagues are the problems. They especially don't recognize it when they themselves are the problem. So how would they recognize the wall they have built between patients and the truth?
The Great Sidewalk of Medicine
Something I hear repeatedly from people in medicine is that the rest of the world could not "understand" the tough calls, the gray areas, the complexity of medical knowledge. As though a patient would need a medical degree to know if she were being raped. And would be incapable of recognizing when no one would report it.
When a self-interested behavior is the norm accepted by all of your colleagues, perspective has little chance. Walls appear to be merely the sidewalks you walk on.
That's why the patient community needs to get the information it itself.