Pagers are still surprisingly common in hospitals, despite their clunky nature. Doctors share their frustrations about relying on outdated technology when modern solutions are available. One engaging story follows two doctors trying to eliminate pagers, revealing unexpected lessons about resistance to change. The podcast also explores the cultural significance of pagers in medical environments and the communication challenges introduced by new technologies. It highlights how shifting from pagers to texting could improve patient care while complicating communication dynamics.
Resistance to change, power dynamics, and identity play significant roles in the adoption of new technology in organizations.
Successfully replacing outdated technology requires comprehensive implementation and addressing cultural challenges.
Deep dives
Pagers in the Medical Field: Surviving Obsolete Technology
The use of pagers as a communication tool in hospitals, particularly among doctors, has persisted despite advances in technology. While pagers were once ubiquitous among business professionals and even celebrated in rap songs, they have become largely outdated with the advent of cell phones. However, doctors continue to rely on pagers for communication, raising the question of why the medical profession has not transitioned to more modern methods of communication. Mary Mercer, an emergency room doctor, found herself questioning the ongoing use of pagers in her own hospital and embarked on a project to replace them with a secure messaging app. Although the new technology offered benefits such as bidirectional communication and the ability to send photos, it faced resistance from junior doctors and consulting residents who preferred pagers as they offered a sense of control and power. Despite efforts to implement the new app and improve efficiency, the project ultimately failed to deliver significant value to patients or fully replace pagers, highlighting the complex dynamics of technology adoption in organizations.
The Challenges of Phasing Out Outdated Technology
Marian Mary's experience reflects a wider challenge faced by organizations when attempting to phase out outdated technology. Whether it's pagers in hospitals or fax machines in banks, even when newer and more efficient alternatives exist, resistance to change can be strong. Factors such as risk, habit, identity, and power play a significant role in determining the success or failure of technology adoption. Concerns about battery life, network reliability, and habituated routines associated with pagers highlight the risks and habits that influence preference for the older technology. Additionally, pagers can symbolize the identity of doctors and their professional status, giving them a sense of authority and respect. Lastly, the power dynamics in an organization can be disrupted when new technology changes who has control over communication. In the case of the texting app, junior doctors lost a degree of control and autonomy they had with pagers, leading to resistance and a decreased willingness to adopt the new system.
The Importance of Implementation and Culture Change
The failure to replace pagers with a more modern communication system in Mary's hospital can be attributed, in part, to the lack of comprehensive implementation and a failure to address the culture surrounding the use of pagers. Simply introducing a new technology without considering the potential drawbacks and challenges it may pose can lead to disillusionment and resistance. In this case, the transition from pagers to the texting app required a cultural shift in the way doctors communicated and interacted with each other. Long-standing unwritten rules and routines associated with pagers needed to be replaced by new guidelines for using the app effectively. Overcoming the paradox of increased communication, where more communication does not necessarily improve communication, necessitates a holistic approach that includes not only upgrading the technology but also reshaping the organization's culture and norms.
Remember pagers? They were huge in the 80s — these little devices that could receive short messages. Sir Mix-A-Lot even had a song about them! But then cell phones came along, and pagers more or less became obsolete.
Except there's one group of people who still carry pagers: medical doctors. At a surprisingly large number of hospitals, the pager remains the backbone of communication. Need to ask a doctor a question? Page them. Need to summon a doctor to an emergency? Page them. And then... wait for them to call you back.
Almost everyone agrees that pagers are a clunky and error-prone way for doctors to communicate. So why do so many hospitals still rely on them?On today's show: A story about two doctors who hatched a plan to finally rid their hospital of pagers. And the surprising lessons they learned about why some obsolete technologies can be so hard to replace.
This episode was hosted by Jeff Guo and Nick Fountain. It was produced by Sam Yellowhorse Kesler. It was edited by Keith Romer and fact-checked by Sierra Juarez. It was engineered by Robert Rodriguez with help from Maggie Luthar. Alex Goldmark is Planet Money's executive producer.
