Year of the Test Scandal

An article in the USA Today recently discussed the epidemic of test tampering by teachers.  In fact, they are calling 2011 the year of the Test Scandal.  What does this have to do with medicine, you ask?  Actually, a lot.  The No Child Left Behind Law parallels the Pay-for-Performance concept in healthcare; they are just a few years ahead of us.  I have blogged about this before.  In the school example, evidence of teachers changing test grades were found in Washington DC, Atlanta and NJ.  This is nothing to sneeze at as Georgia law says anyone tampering with test papers faces up to 10 years in prison for falsifying public documents.  The article states that lawmakers are still comfortable tying teacher pay to test scores and that new generation of computer-based tests will be harder to game.  Is that really the point?  The pressure of NCLB is doing this.  In fact, who is to say that it is better to teach the kids to the test or actually teach them to learn and then cheat?    What we are seeing here is what we will see with healthcare.  Doctors will change what scores or readings that they can (blood pressures) and crank up medications in order to get better scores for patients (diabetes, cholesterol) at the risk of even hurting patients.   If this doesn’t work physicians can just fire the patients for “noncompliance”.  This would be an “erasure” of a different kind.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  3 comments for “Year of the Test Scandal

  1. Bridget Reidy
    January 12, 2012 at 4:39 pm

    Why Why Why is no one but Doug saying this? Am I the only doctor besides him that knows that hypoglycemia kills brain cells? How do we us live with ourselves allowing this kind of crap.

  2. January 11, 2012 at 6:45 pm

    This is already happening in healthcare. When I worked for a hospital as a Core Measure Reviewer I abstracted from an ER document in a patient’s chart during a preliminary Acute MI review. Unknown to me the patient’s arrival time on that document had been overwritten. This effectively took one hour off the patient’s Door to PCI time and initially brought accolades to the team for improved scores. The person who changed the time was apparently unaware that the original ER document had already been scanned into the patient’s chart and upon my follow up review of the complete chart the deceit was discovered.

  3. gerridoc
    January 11, 2012 at 6:08 pm

    I agree. I refer to the Diabetic pay for performance as guidelines “No diabetic left behind”

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