For years I have pointed out the similarity between doctors and teachers. Two years ago I said this:
The teaching profession is ahead of us by a few years. Watch how it is crumbling and how some states are finally getting rid of the core competency BS. We need to do the same with the “quality” movement before it is too late.
Three years ago I said this:
I have highest regards for teachers. My mom was a science teacher. My wife was a special education teacher. If you have read this blog you know that I have used examples of what is happening to them to show how doctors are following in the same path.
Now let’s bring this to the healthcare system. You are making doctors quit with unproven benchmarks and quality indicators, ridiculous mandates, disrespect, EMRs and loss of control.
and even this five years ago:
Who knows but to give “quality” grades to doctors that depend on patients’ compliance is like basing teachers’ pay on the tests scores that their students achieve. Who is crazy enough to do that?
We are heading towards “No Patient Left Behind” which will fail miserably.
I point this out because the NY TIMES just did a piece called How Measurement Fails Doctors and Teacher and it just made me grit my teeth. The highlights:
- TWO of our most vital industries, health care and education, have become increasingly subjected to metrics and measurements. Of course, we need to hold professionals accountable. But the focus on numbers has gone too far. We’re hitting the targets, but missing the point.
- All of this began innocently enough. But the measurement fad has spun out of control.
- There are so many different hospital ratings that more than 1,600 medical centers can now lay claim to being included on a “top 100,” “honor roll,” grade “A” or “best” hospitals list.
- Education is experiencing its own version of measurement fatigue. Educators complain that the focus on student test performance comes at the expense of learning.
- But the objections became harder to dismiss as evidence mounted that even superb and motivated professionals had come to believe that the boatloads of measures, and the incentives to “look good,” had led them to turn away from the essence of their work.
Am I trying to gloat about my prediction? Of course I am. I also want to point out, however, that the idiots in charge of both our education system and our healthcare system are NOT going to give up that easily. Why? No one likes administrators. You know it. I know it. They know it. The most trusted professions in this country, by far, are doctors (and nurses) and teachers. Administrators are no where to be found on that list. So what is the best way to gain control over these systems? You need to create distrust between patients and doctors or parents and teachers. How do you do it? You create a false need for bogus quality indicators and metrics. You hire other administrators and call them consultants to publish studies “supposedly” supporting these metrics. You control the media and what is said to the media. You create a crisis in both systems. These crises, which infer that teachers and doctors need more oversight, create doubt in the public’s mind. It allows administrators to hire more administrators. It allows administrators to be the bosses they need to be in order to play chess with the jobs of doctors and teachers. It allows administrators to get gold stars and top honors for their hospital and themselves. It allows administrators to get paid a lot of money. And that is where we are today. Any questions?Tweet