Increasingly, I worry about the rise of measurement by omnipresent devices like the iPhone, whoop, and oura ring. When we overly quantify our life, we suck dry the nectar that is its precious quality.
Interesting a common metric used for physicians is the work revenue unit (wRVU). Basically just about every procedure from an initial office visit to a heart transplant has a number of wRVU assigned to it. The MGMA does yearly surveys and assigns benchmarks based on speciality.
So a Family Medicine without OB doctor may have 25% benchmark of 2,500, 50% of 5,000, 75% of 9,000 and maybe 90% of 12,000. Note this doesn't necessarily go up linearly. Going from 25% to 50% maybe easier than going from 50% to 75%. As often happens, a place may hire a doctor for less than a full FTE, so in that case you'd simply adjust the benchmarks accordingly.
The concept is the physician you hire at your hospital or practice can't control what type of coverage the patients have so the best way to measure them is to ask are they doing billable services? The wRVU allows you to put different services together. This also seems to drive the philosophy many pick up on with modern doctors of being quick with patients. If you think of it like NASCAR, the physician is like the driver. He has to be on the road as much as possible so if doubling the size of the pit crew to get him back on the track 5 seconds sooner will work, you do it.
This is not how every practice does it. Sometimes you get physicians just 'on staff'. Private practices may often follow "you eat what you kill", meaning the doctor is rated simply on the revenue they generate whether that's a few patients with generous insurance or lots of patients with stingy.
I think it maybe just as helpful to ask what works when metrics go right?
I think some 'bad metrics' are simply about revealing what something's true purpose is about.
For example, it's pretty common for people to tout rapid eduction. "I taught myself calculus in 3 weeks rather than a full semester". "I homeschooled my kid and took her from 3rd grade reading to 5th in less than a year" etc. Why doesn't everyone just copy that?
Because schooling is a holodeck. It's purposes are:
1. Kill time by occupying kids.
2. Keep the kids out of grownups hair for a good portion of the day so stuff can actually get done that needs doing.
3. Provide kids a period of fantasy where they can climb social ladders, rise to the top or fall to the bottom. Why do we need that? Because grownup life moves very slowly and the drama of the 'arc' will be hard to see if you just start it cold.
The learning and test scores are nice to haves that ride along with that train. But note these things are either hard to put into metrics or would be metrics that would tend to turn people off if you were too honest about them.
Increasingly, I worry about the rise of measurement by omnipresent devices like the iPhone, whoop, and oura ring. When we overly quantify our life, we suck dry the nectar that is its precious quality.
Yeah there's definitely a balance to be struck. And everyone these days is bad at moderation.
Everything in moderation, including moderation!
Interesting a common metric used for physicians is the work revenue unit (wRVU). Basically just about every procedure from an initial office visit to a heart transplant has a number of wRVU assigned to it. The MGMA does yearly surveys and assigns benchmarks based on speciality.
So a Family Medicine without OB doctor may have 25% benchmark of 2,500, 50% of 5,000, 75% of 9,000 and maybe 90% of 12,000. Note this doesn't necessarily go up linearly. Going from 25% to 50% maybe easier than going from 50% to 75%. As often happens, a place may hire a doctor for less than a full FTE, so in that case you'd simply adjust the benchmarks accordingly.
The concept is the physician you hire at your hospital or practice can't control what type of coverage the patients have so the best way to measure them is to ask are they doing billable services? The wRVU allows you to put different services together. This also seems to drive the philosophy many pick up on with modern doctors of being quick with patients. If you think of it like NASCAR, the physician is like the driver. He has to be on the road as much as possible so if doubling the size of the pit crew to get him back on the track 5 seconds sooner will work, you do it.
This is not how every practice does it. Sometimes you get physicians just 'on staff'. Private practices may often follow "you eat what you kill", meaning the doctor is rated simply on the revenue they generate whether that's a few patients with generous insurance or lots of patients with stingy.
I think it maybe just as helpful to ask what works when metrics go right?
XKCD demonstrated something similar to this some time ago:
https://xkcd.com/927/
I think some 'bad metrics' are simply about revealing what something's true purpose is about.
For example, it's pretty common for people to tout rapid eduction. "I taught myself calculus in 3 weeks rather than a full semester". "I homeschooled my kid and took her from 3rd grade reading to 5th in less than a year" etc. Why doesn't everyone just copy that?
Because schooling is a holodeck. It's purposes are:
1. Kill time by occupying kids.
2. Keep the kids out of grownups hair for a good portion of the day so stuff can actually get done that needs doing.
3. Provide kids a period of fantasy where they can climb social ladders, rise to the top or fall to the bottom. Why do we need that? Because grownup life moves very slowly and the drama of the 'arc' will be hard to see if you just start it cold.
The learning and test scores are nice to haves that ride along with that train. But note these things are either hard to put into metrics or would be metrics that would tend to turn people off if you were too honest about them.