Among the Mafia and some other groups, there’s a strong cultural drive to stay silent and never admit wrongdoing. This is part of a more general reaction against organized authority and strong allegiance to the group. In many cases, allegiance to smaller units is actually the better way to organize. Often the large centralized organizations are remote and uncaring, lacking local knowledge and with little commitment to serving the community. The usual loyalty is to teams within the central organization without direct interest in promoting service standards. In the healthcare industry, we see this in the building of large and impressive hospitals. The staff who work in these shining towers of excellence are paid the highest salaries, they have the best working conditions, and their status is supreme. In such a hierarchy, no one wants to work in the community where the pay is significantly less and the work of dealing with actual patients is far more demanding.
In other countries, the emphasis is on primary care in the community with local groups of nurses and support staff led by dedicated teams of general practitioners. Wherever possible, people are treated in their homes. This avoids the need to build massive central hospitals. It also treats the patients with individual dignity, strengthens the family support networks, and helps maintain quality of life. Shipping every patient off to a hospital strips them of their independence and turns them from a person into a file number.
Yet there does remain a core problem. For all doctors and nurses develop better relationships with the patients and their families, there are still medical problems people prefer not to admit. Erectile dysfunction falls within the code of silence. This is ironic.
Cialis is a convenient and effective treatment. More importantly, restoration of sexual activity has a strongly beneficial effect on the quality of life within families. Yet unless people ask for help, it cannot be given. The Cialis sits in its bottle or blister pack, a victim of shame and embarrassment. The only hope is for the men to buy online. That does maintain their privacy.