I was 35, a Clinical Engineer (CE) for 6 years, and in the midst of discovering my professional identity when my ‘aha moment’ came. When did yours come, or has it yet? A life-changing experience … where did mine happen? The year was 1985 in Asunción, Paraguay. Why there, and why then? For that, we need background.
Where did this CE come from? As a high school senior, I was thinking pre-med, my grandfather had been an OB/Gyn physician. But at that last moment, I got an appointment to the Naval Academy-USNA, and my career plans changed. The year was 1968, and the astronaut possibility was very compelling. Twenty days after high school graduation, that journey began and the next steps were an undergraduate degree in Aerospace Engineering-AE, a one-year AE Masters, and flight training. That went well, and I moved toward my opportunity as a Navy jet pilot with great excitement – regularly pushing the edge in myself and the technology - I can tell you stories …. After getting Navy wings, there was to be six months of specialized training in my assigned aircraft before joining ‘the fleet’, eg, joining a squadron based off of aircraft carriers.
Five months later, at high speed at night, I found out about my persistent eye challenges previously undetected. As this was early 1975 and my country’s military involvement in Vietnam was ending, my Navy superiors determined I should find another way to serve. This I appealed for six months but was left … off flight-status. It was a time for deep reflection, a time to ask God for guidance, and I did. Coming back to an earlier focus, I felt led to the biomedical engineering-BME field, to use my background in engineering and management to serve. For my remaining Navy commitment, I was given an opportunity to teach systems engineering at USNA by day, including flight simulation. By night, I was able to enter nearby Johns Hopkins University’s BME program and was quickly overwhelmed by the breadth of this emerging field, yet deeply satisfied. Clearly, lifelong training would be required.
Upon departing the Navy in 1979, I became a CE at Johns Hopkins Hospital, managing a new hospital-wide equipment PM program. I met some talented young CEs in those days, with similar and different skills. With full implementation of the program by the next year, this now 30-year-old in 1980 moved to Florida to begin a new CE department in a large community medical center-BMC.
The Navy had instilled in me a spirit of taking initiative, building a team, and pushing back the barriers in the field of endeavor. As a 4-year plan emerged and with great support from the C-Suite (hospital leadership), our growing team progressively took on ‘General Biomed’, Imaging, Lab, and then Computer HTM; in the 5th year and following, we took these skills sets as a BMC to the wider community and several-hundred-mile radius as a for-profit company.
These were mind-expanding days for sure, exploring the edge of what CEs could do. I was inspired by other CEs; only three of us in Florida initially, but found encouragement from many national colleagues at annual meetings, got certified, joined the Board of Examiners in 1984, and taught Biomed at the local 2-year college.
So finally back to 1985 … So how do we find out where we best serve … both in our personal and our professional lives. Of course, this is a journey of discovery for all of us. Part of my earlier personal learning is that I was drawn to serve high school kids, probably because I had a hard time growing up (some would say still not grown up 50+ years later, ha ha).
I was able to do this kind of volunteer work with my wife, beginning the year we were married (10 days after college graduation) and it quickly became a key focus of our personal time. As I worked with kids in a faith-based community organization, I heard their difficult questions about life, and was drawn to Biblical values to help address the many challenges kids face. This framework had also caused my worldview to expand to see all races and cultures of equal value to God. So when my hospital in 1985 wanted to send me to Paraguay for two weeks to assist a ‘missions’ hospital, I was excited for this opportunity. The hospital in Asunción was building a new wing and making many medical equipment decisions; here was a natural opportunity to explore using my skills in another environment, unique in its own ways, and with many different kinds of challenges.
Those two weeks, as I stayed with the (delightful gringo) hospital administrator and his family, I saw our CE profession in new light, my ‘aha moment’. Yes, we were about improving the quality of healthcare and lowering costs, but more than that … we were part of giving hope to communities, making healthcare discoveries and emerging technologies available in practical ways to brothers and sisters from all over. I was hooked!
And that time in 1985 has provided a key guiding principle for my last 35 years. I had begun to learn it is not about what American CEs (or anyone country’s CEs) can do, it is about how we can find and encourage our colleagues the world over … and share together our experiences and capabilities to make all of our communities better.
Sounds good, but what were the next steps? A few of the highlights; the challenges continue in 2019 (and now 2022)! I chaired the US CE Certification Board 1987-1989, where it became apparent our role in the US was under-recognized. In that role, we read WHO’s study about CE-HTM global status, WHO/SHS/NHP/ 87.5, Interregional Meeting on Maintenance and Repair of Health Care Equipment - whose cover quote states - see https://apps.who.int/iris/handle/10665/62426: ‘In one South American country, it is estimated that the replacement value of medical equipment is $5 billion. Forty percent of this is not functioning, representing a loss of $2 billion (annually).” While only $400 million is spent annually for medicines”. Terrible! Four USA CEs (David, Judd, Painter, Morris) joined WHO’s next CE-HTM global study in 1989, WHO/SHS/NHP/90.4 – Manpower Development for a Health Care Technical Service https://apps.who.int/iris/handle/10665/62102.
One of us Dr. Yadin David led the creation of the American College of Clinical Engineering in 1990; ACCE began the Advanced CE Workshops (ACEW) in 1991 https://accenet.org/International/Pages/PreviousWorkshops.aspx. By 2015, there had been 50 ACEWs, involving over 75 countries, and over 4000 participants; see 2013 report at WHO’s 2nd Global Forum on Medical Devices, www.who.int/medical_devices/global_forum/Workshop_16_HTM_ACCE.pdf. Now in 2022, IFMBE CED – with its over 500 Board and Collaborator members from nearly 200 countries https://ced.ifmbe.org/about-us/who-we-are.html - has an opportunity to help one another outline our profession’s Capacity Building (CB) and Impact Measurement (IM) capabilities across the globe. Join us in this worthy effort. Thanks!
Tom Judd, IFMBE CED Board Chair (Term: 2018-2022)
PS: Dr. David, Interim President of GCEA, and I have discussed beginning a new video series later this year, where we focus on one country at a time and facilitate their telling of their Clinical Engineering CB and IM development story. Stay tuned. There are many great stories to tell, and many others not yet written.