Favorite Quotes
"For every complex problem, there is a solution that is simple, neat, and wrong." - HL Mencken
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"I hear and I forget. I see and I remember. I do and I understand." - Confucius
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"The good physician treats the disease; the great physician treats the patient who has the disease" - Sir William Osler
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" The best test of a person's character is how he or she treats those with less power." - Bob Sutton
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"Those are my principles, and if you don't like them - well, I have others." - Groucho Marx
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"The difference between genius and stupidity is that genius has its limits." - Albert Einstein
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"It is hard enough to remember my opinions, without also remembering my reasons for them" - Friedrich Nietzsche
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"Anyone can make the simple complicated. Creativity is making the complicated simple." - Charles Mingus
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"Not everything that can be counted counts, and not everything that counts can be counted." - Albert Einstein
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"A foolish consistency is the hobgoblin of little minds, adored by little statesman and philosophers and divines. With consistency a great soul has simply nothing to do." - Ralph Waldo Emerson
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"This ain't no party, this ain't no disco, this ain't no fooling around." - Talking Heads, Life During Wartime
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"What is hateful to you, do not do to your neighbour. This is the whole Torah; all the rest is commentary. Go and learn it." - Hillel, Talmud, Shabbath 31a
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"You will never understand bureaucracies until you understand that for bureaucrats procedure is everything and outcomes are nothing." - Thomas Sowell
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"An idealist is one who, on noticing that a rose smells better than a cabbage, concludes that it will also make better soup." - HL Mencken
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"If you only have a hammer, you tend to see every problem as a nail." - Abraham Maslow
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"A great teacher is one who realizes that he himself is also a student and whose goal is not to dictate the answers, but to stimulate his students creativity enough so that they go out and find the answers themselves." - Herbie Hancock
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"There are no facts, only interpretations." - Nietzsche
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"An education isn't how much you have committed to memory, or even how much you know. It's being able to differentiate between what you do know and what you don't." - Anatole France
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"In character, in manner, in style, in all things, the supreme excellence is simplicity." - Henry Wadsworth Longfellow ====
Nov - 15
Dec - 19
Jan - 21
Feb - 8
Mar -
Measurement – the good and bad
25 Aug2009
This is my fault. A frequent commenter and blogger missed the context of a sentence in a recent rant. The sentence is confusing and thus the mistake is mine.
Here is the context – In which curious challenges me. I said “I favor limited guidelines, but not measurement. Measurement has too many unintended consequences.” I am quoted here – Just because it’s not easy to measure …
What should I have written? I have no problem with carefully considered measurement, when the measurement has rationale and data supporting the usefulness of measurement.
Let me give some examples. I do not want insurers or independent ranking groups looking at the percentage of my diabetic patients who have a HgbA1c < 7. I would be happy to receive a report of the distribution of the HgbA1c values of my diabetic patients – with names attached so that I could review their care and address those patients who qualify for more aggressive therapy.
What I should have written is that I am opposed to using performance measures as a surrogate for physician quality. We do need to measure the things that Krouwer discusses. We need to measure safety problems. We need to measure test characteristics.
So I apologize for a bad sentence. I meant one thing, but the way I wrote the sentence it was easily interpreted as something else. Not all measurement is bad, but in general we should restrict using performance measurement to inform physicians, not to incent, reward or rank physicians.
Related posts:
- Quality measurement – a delusion
- Can we measure quality?
- What is quality – a reader asks
- Safety rather than quality
- In which curious challenges me
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- In: Medical Rants