So, let’s take a look at a hypothetical situation, even though you know it’s really not all that hypothetical, but whatever.
A certain provider has been observed, over a period of months, to take blood pressures that always ended in zeros and were almost without fail in the same range, i.e. 140/90, 130/80, etc. Well, that’s if he even bothered to take an auscultated blood pressure, and not a lazy palpated one. He also is apparently never able to measure anything under 110 – “I can’t hear it…” – while the next person who handles it never has any trouble getting 82/54 or 66/44.
Kind of a problem, especially if there’s hypotension involved, isn’t it?
No one really says anything, because there is a concern that he’ll just end up making stuff up if anyone points out that his blood pressures are crap, since there really is no real-time way to confirm his measurements. Instead, fellow providers just make sure, on actual legitimate patients, that they don’t waste time letting him take any blood pressures.
At some point, perhaps because someone has spoken to him, he begins to be observed to report blood pressures that are intricately accurate-soundin… uh, I mean, what normal providers obtain, i.e. 124/66, 158/92, etc. It’s also observed that he takes 4 times longer than before to get these numbers.
So now, several possibilities are evident:
The logical person would simply conclude that nothing he says is to be believed. Ever.
It’s difficult to see the good in people.
Once you’ve shown that you can’t be trusted, it’s over. And that extends to everything else you do.