Comment by AllegedAlec
2 days ago
> 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.