When No One Comes to Save Us: The Case for Diplomatic Defiance in Healthcare
“Say the thing. Stand on your square and lean into the truth courageously.”
Last week, a supporter - let’s call her Kelly - shared a painful story. A loved one underwent a medical procedure that turned out to be traumatizing for both of them.
Kelly grew up in a family of physicians. Her parents and their friends were staunch patient advocates, trusted experts, and community leaders. As a non-physician clinician herself, Kelly has spent decades working on medical teams and putting full faith in the healthcare system , dutifully adhering to physician recommendations for everything from screening tests to surgery.
But over the past five years that faith has shattered.
Her trust has given way to fear and disappointment. In delicate situations, she and her loved ones were handed off to less qualified professionals. The most recent incident - a clumsily performed an ultimately unsuccessful procedure - left her loved one in pain, fearful, and something we too often ignore, stripped of dignity. A similar lapse just a few years earlier nearly cost Kelly her life.
Regretfully, she no longer believes physicians can consistently uphold their ethical duty to protect patients if doing so might jeopardize their productivity or their jobs.
The Corporate Capture of Care
For decades, physicians have operated within the strict constraints of law, regulation, and professional standards - limitations they accept to protect patient safety. Administrators also face legislative and regulatory constraints, while navigating financial risks. But the safeguards for physicians don’t apply to administrative “innovations,” when power and profits are on the table.
As one physician told us, “We just keep hoping that the cavalry is coming. And they're not."
The Calvary Is Not Coming… But We Are.
This is the reality: We are the cavalry. To protect our patients (and our profession) we must accept a few truths:
No one is coming to save us. We are the ones we have been waiting for.
Healthcare is morally and ethically complex. We need fluency in those complexities, not just technical competence.
When either patient safety or professional integrity is at risk, it is time to practice diplomatic defiance or face complicity.
What Is Diplomatic Defiance?
We’ll explore this more deeply in an upcoming article, but here’s a preview:
Diplomatic defiance is a skill. It’s the art of pushing back in ways that those in power can hear.
It starts with recognition, knowing when your morals, ethics, or values are at risk of compromise.
State the problem and the stakes. Name the threat and articulate its consequences.
Make the right ask, the right way. Ground your request in ethics, evidence, and impact.
Practice matters. Even small moments of resistance build skill and confidence.
Discomfort is part of the process. If activism feels easy, you may not be going far enough.
It’s Time to Speak Up Together.
It is time to stand firm in our professional values. It is time to name what is broken.
It is time to defend patients and each other.
Are you ready to lead with courage?