Guest column: Can ‘Big Brother’ keep your hands clean? |

Guest column: Can ‘Big Brother’ keep your hands clean?

Ira Bedzow
Guest column

In a recent Harvard Business Review article, Gretchen Gavett wrote about an experiment that was meant to counteract the tendency of caregivers who were less likely to wash their hands according to standard procedure as their shifts progressed. In order to keep a high level of compliance, companies monitored their employees across 42 hospitals over a 31/2-year period.

Monitoring employees did lead to an increase in hand-hygiene compliance, especially when employees were made aware of it. However, once the monitoring stopped, compliance rates dropped to below their previous levels, which originally had dipped below 50 percent compliance in some companies.

This type of monitoring has roots in Jeremy Bentham’s panopticon — where a circular structure (of prison cells) surrounded an “inspection house” at the center, from which the manager or staff of the institution would be able to watch the inmates. The thought behind the panopticon was that though it’s physically impossible for the single watchman to observe everyone at the same time, inmates cannot know when they are being watched. Therefore, all the inmates would act as though they are being watched at all times, effectively controlling their own behavior constantly.

The problem with such a management strategy is that those who are being monitored control their behavior for an external reason. They do not build intrinsic motivation to maintain new habits. They are being coerced and not trained. Therefore, when the external factor is removed, so goes the habit.

Changing habits requires changing the way we view old habits and the importance of new ones. It is not enough to change what we do; leaders must show us why we want to change, as well.

Ira Bedzow is the director of the Aspen Center for Social Values and on the faculty at New York Medical College, where he teaches medical ethics. Bedzow will be leading the Ethical Leadership Conference in Aspen from Sept. 18 through 21 at the Jewish Community Center. The public is invited to a panel discussion on Sept. 19 at 5:30 p.m., “How Physicians and Pharmaceutical Companies Relate to Patients,” and another on Sept. 20 at 6 p.m., “Teaching Ethics to Medical, Business and Law Students.” Please RSVP to For more information about the center’s programs, go to or http://www.aspenethical​

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