Comment by jaredklewis
2 days ago
News to me. How do you determine the productivity of a doctor? Patients seen? Patients cured? (for real, where did you get that data?) Number of medicines prescribed? Procedures performed? Does a triple bypass surgery count the same a pap smear? Hours worked? Amount of help they provided to colleagues? Easy to come up with another 100 other metrics that might be worth looking out. How are they all weighted?
Like I get that in SWE (like all other fields), managers have to make judgement calls and try to evaluate which reports contribute the most, but the GP post seemed surprised that this wasn't a solved problem by now, which just seems incomprehensible to me.
> How do you determine the productivity of a doctor?
At the end of the road. Patient outcome and contentedness compared to others with similar indications. Patients seen and all that is that sort of short-term BS that you see everywhere that's giving metrics a bad name. It'd be like determining a mechanic's productivity by how many times he twisted a wrench.
> Patient outcome and contentedness compared to others with similar indications
Which would incentivise doctors to refuse to treat patients who are more ill, lest they risk their ratings go down.
> Patient outcome and contentedness compared to others with similar indications.
and how you would achieve it? "similar indications" would be coming from doctor that you are trying to rate
rating "contentedness" gets you doctors prescribing useless medications to keep patients happy
expert surgeons have often bad survival rates as they get complicated cases, and trying to rate how complicated cases are to compare two experts would be nightmare as bad as rating doctors - so you only replace one hard problem with another as hard problem
> At the end of the road. Patient outcome and contentedness compared to others with similar indications.
Well I would first of all remark that this doesn’t seem and to be how it’s normally done as I’ve never been asked to rate my “contentedness” or similar with my medical care.
And where is the “end of the road?” Most medical interventions could be plausibly evaluated at all manner of different intervals.
Also, “similar indications” is doing a lot of work here. Patient outcomes are often influenced more by the individual than the doctor. By the time you bucket all the patients by age, diet, activity level, smoking status, alcohol intake, metabolic health, bmi, family history, etc…buckets are going to be pretty tiny. Clinics and hospitals aren’t that big, there won’t be anything to compare. If you only bucket the most obvious categories like age, you’ll have comparisons, but it will just be noise.
life expectancy, standardized qol metrics. or patients seen, revenue per patients, hours worked etc can be metrics if those _were_ what you wanted. the point is, the answer is yes, they have measures of better/worse docs in their field.
Yea, those are all pretty shit metrics.
We have that shit like that too in SWE. Lines of code, github issues closed, features shipped, etc…