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Our top priority is providing value to members. Your Member Services team is here to ensure you maximize your ACS member benefits, participate in College activities, and engage with your ACS colleagues. It's all here.
Is This Really about Tape? What Our Systems Reveal about Institutional Trust
Satyan K. Shah, MD, FACS
May 6, 2025
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Dr. Satyan Shah
I was recently pondering something seemingly mundane while on rounds.
It was 7:00 pm, and I needed tape—3-inch cloth tape, to be specific—the kind many urologists use to secure catheters with a mesentery. But I was pensive because of what happened next.
After finding the patient’s nurse, I walked halfway down the ward with him to the supply room. I swiped my badge to enter and then made several attempts at a fingerprint scan before the medical dispensing system finally granted us access. It took another minute to scroll through the registry to find the patient and open two doors—all of this effort for a roll of inexpensive tape.
Sound familiar? It’s the same process many hospitals employ to distribute routine supplies—gauze, spirometers, and even, syringes. But I couldn’t stop thinking about why a surgical floor would safeguard such a basic item. Inventory management makes sense. Accurate billing is logical. But is that all? Did the hospital think doctors might waste the tape? Hoard it? Or take it home?
I felt uneasy over these possibilities. Uneasy because they indicated a lack of trust. In the days ahead, I began to question other common practices, like why I was constantly waving my badge around the hospital. It made perfect sense to enter the operating room or park in the employee garage. But I was having a harder time understanding why a badge was necessary to access the conference and break rooms.
As it happened, the next day, I had several surgeries scheduled. My first stop was at the automated scrub dispensing machine. I scanned my badge and retrieved a pair of purple scrubs. Except this time, a medium pair had been mistakenly stocked in the large slot. So, I scanned my badge a second time to return them for credit, and that’s when my attention turned to a small video camera recording the scrubs as they fell into the bin. It was a camera similar to those used to deter criminal behavior at airports and casinos. Did hospital leadership think people would deposit hospital gowns (which aren’t locked up) to earn scrub credits? My heart sunk. I was starting to feel like a pat down was coming next.
I chuckled at the irony of hospitals trusting surgeons to perform complex procedures, but not to return their scrubs. With all the background checks, licensing boards, and credentialing committees, it seems fairly unbelievable that physicians may be thought of as potential petty thieves. Perhaps the Hippocratic Oath needs to be updated with a pledge to not steal hospital property.
Incidentally, many years ago, scrubs were kept on open shelves in the locker room. It may be hard for someone in 2025 to imagine, but the system worked well. Did surgeons occasionally take a pair home to wear on call? Yes. But that was the exception as most changed back into dress clothes after the OR. It was rare to have a size missing, which is why I was bothered by the machine’s video camera and the faux pas scrub color.
Here’s another irritation I have experienced: reinvented hand-washing audits. Many hospitals now require physicians to wear a special badge as part of the electronic hand-hygiene surveillance system. Special sensors on the dispenser in patients’ rooms sense provider compliance. Lest one forget, it gives an audible/visual alert as the physician approaches the patient, typically with red lights and beeps. Although well-intentioned, this kind of alert has the potential to erode patient trust in their physician, no matter how compliant subsequent hand hygiene is thereafter.
Some may argue these grievances are simply a result of modernization, which conveys necessary information to hospital leadership. But it’s notable that security and compliance are often touted in the marketing of many of the products and systems described herein. As for the issue of theft, it would be naïve to think any system could fully eliminate it. It is a critical mistake to implement policies that potentially mischaracterize the majority of healthcare providers.
In this time of increased focus on physician wellness, hospitals must guard against sending messages of mistrust. Wellness measures should include an assessment of the effect new technology has on employees. These changes may help foster “vertical bonds of trust” that hospital leaders need.1 As Clara Berridge, PhD, MSW, a gerontologist from the University of Washington in Seattle, said, let us be careful of treating physicians like “suspects who have to be deterred from bad behavior.”2 It’s prudent to keep this in mind, even if there are a few among us wearing scrubs as pajamas and using their dirty hands to box gifts with cloth tape.
Acknowledgment
Sincere thanks to Molly Peckham, MD, for her invaluable contributions to the development of this article.
Disclaimer
The thoughts and opinions expressed in this column are solely those of the author and do not necessarily reflect those of the ACS.
Dr. Satyan Shah is a professor of surgery and urologist at The University of New Mexico School of Medicine in Albuquerque.
References
Heifetz RA, Linsky M, Grashow A. The Practice of Adaptive Leadership: Tools and Tactics for Changing Your Organization and the World. Boston, MA: Harvard Business School Publishing: 2009.