I heard a story on the radio about a survey conducted by the Josephson Institute of Ethics regarding high-school character and adult conduct.1 It reminded me of a story I was told by a friend about one of his classmates, whom I will call Dr. A.As a chiropractic student, this future chiropractor found many "interesting" ways to help pay for school. The future Dr. A collected empty beer cans at the bottling plant he worked at and turned them in for the deposit - theft from his employer. He fraudulently obtained USDA food stamps and welfare, a federal offense. Within a couple of days of the opening of a blockbuster movie, he was selling bootlegged videotapes, another federal crime. In fact, he had a large cache of bootlegged videotapes he tried to sell to his classmates.
Although most of the future Dr. A's classmates knew about his various illegal activities, none felt compelled to "turn him in," as they viewed his offenses as petty crimes. This is similar to the scenario described in the preface to The Cheating Culture. Author David Callahan tells about a friend who shoplifted $40 bottles of Bordeaux, a misdemeanor. People found this behavior indicative of a mental illness. On the other hand, another friend of Callahan's who regularly committed tax evasion, a felony, was thought by his peers to be clever by illegally avoided taxes.2 Some people's judgment of the degree of illegality of an act has no relation to the real severity of the act.
My friend told me that years later, he found out Dr. A had apparently spent years abusing the third-party system. In fact, his behavior caused significant statewide restrictions on chiropractic insurance benefits, even causing some insurers to write chiropractic out of their policies. In the end, Dr. A was convicted of insurance fraud - but not until the damage was done to the whole profession in his state.
In 2008, another Josephson Institute survey revealed that dishonesty was very prevalent among high-school students, with approximately two-thirds cheating on exams and one-third stealing from a store. Some people excuse immoral behavior on the part of youth by dismissing it as youthful indiscretion they will grow out of one day. The latest Josephson Institute survey challenges that belief.
The 2009 survey involved approximately 7,000 people in four age groups (17 and under, 18-24, 25-40, 41-50, and over 50). Among the findings and particularly germane to health care, the survey revealed that regardless of age, people who had cheated on a high-school exam were three times more likely to inflate an insurance claim. The founder of the Josephson Institute commented, "This study confirms unequivocally that character counts now and in the future and that values and habits formed in school persist."
Now, I don't know anything about Dr. A's propensity to cheat in high school, but obviously his moral compass didn't point in a good direction when he was a chiropractic student and his professional behavior wasn't any better. He didn't change his spots.
I've often heard my students say that the behavior of their classmates is none of their business, as long as their classmates don't directly harm them, by, for example, stealing from them. However, even prior to this new survey, I used Dr. A as an example in my ethics classes of why students need to concern themselves with the behavior of their classmates. Maybe if someone had stopped Dr. A when he was a student and caused him to reflect on the morality of his actions, he might not have screwed up relationships between our profession and the insurance carriers in his home state. It all suggests that a person who displays low moral character in chiropractic college probably won't be a model citizen when licensed - and unsupervised. Leopards don't change their spots.
- "Josephson Institute of Ethics Releases Study on High School Character and Adult Conduct." Oct. 29, 2009. http://josephsoninstitute.org/surveys/index.html
- Callahan D. The Cheating Culture. Orlando, FL: Harcourt, Inc., 2004.
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