tag:blogger.com,1999:blog-1509187841033628660.post3522961923722725533..comments2024-03-28T22:28:39.087-07:00Comments on Medicine and Social Justice: “Good enough for Government Work”: Quality, cost, and gaming the system, Part 1 (of 4 parts)Josh Freemanhttp://www.blogger.com/profile/10248920527894775520noreply@blogger.comBlogger1125tag:blogger.com,1999:blog-1509187841033628660.post-8371149098543334852016-04-09T18:30:16.836-07:002016-04-09T18:30:16.836-07:00Thanks so much for this post and for pointing to t...Thanks so much for this post and for pointing to the culpability of the politicians.<br /><br />It is important to understand these events as examples of Campbell's Law (https://en.wikipedia.org/wiki/Campbell%27s_law):<br /><br />"The more any quantitative social indicator (or even some qualitative indicator) is used for social decision-making, the more subject it will be to corruption pressures and the more apt it will be to distort and corrupt the social processes it is intended to monitor."<br /><br />This means that if you create a very high stakes measure of quality, people will meet that measure even if it means worsening the actual process. The New Yorker had a sad article in 2014, discussing how the pressure to produce high test scores in Georgia (if not schools would be closed, teachers would lose their jobs) led to massive cheating on the part of students and teachers. http://www.newyorker.com/magazine/2014/07/21/wrong-answer<br /><br />We see this every day in EMR's which require us to fill in meaningless boxes in order to get our work done. This corrupts our professional ethic as physicians.<br /><br />This is just one more way in which apparently "tough-minded business thinking" is just plain dumb and destructive.<br /><br />Matt Anderson, MDMatthew Andersonhttps://www.blogger.com/profile/01160604562315966561noreply@blogger.com