The managed care revolution: how medical technologists have tolerated the change.

A repeated cross-sectional study on the psychological profiles and interpersonal styles of highly stressed medical technologists (perfusionists) has found remarkable consistency in internal psychological profiles and differences in interpersonal dynamics over a 6-year period. Six years ago a longitudinal study was begun to track the psychological profiles of perfusionists. Surgeons can repair cardiac defects only after a beating heart has been stopped. In order for the brain and other organs to survive cardiac surgery, they must be perfused with well-oxygenated blood. As a result, the life of every cardiac surgery patient literally sits in the hands of the cardiac perfusionist. The stress of placing patients on and off the 'pump' is one that is experienced by cardiovascular perfusionists on a daily basis. This stress has been likened to that of air traffic controllers who continually prepare planes for take off and/or landing. In the 6 years between studies, medical technologists have changed very little psychologically. They remain very well balanced. However, there have been significant changes in their interpersonal behaviours. Instead of the 'well-balanced' interpersonal profiles of 6 years ago, there is a higher degree of assertiveness/aggressiveness being reported. Managed Care has begun to impact interpersonal behaviours but has not yet altered the more resilient platform of internal psychological balance.