Bob Wachter over at Wachter’s World sees some interesting parallels with the unintended consequences of outcome based education and the No Child Left Behind law. In primary and secondary education, emphasis on the core skills of math and reading has relegated the humanities and other important subjects to the status of “soft” content. (Wachter presents data from the San Diego schools!).
Whether in primary and secondary education or in medicine, one hazard of adopting core measures is that the achievement of minimum standards trumps the pursuit of excellence. One of the many consequences in medicine may be the demise of the master clinicians, the Proctor Harveys of the world. Wachter agrees and shares an anecdote about one of UCSF’s master diagnosticians, Gurpreet “Goop” Dhaliwal, concluding:
I’m afraid that Goop’s diagnostic acumen might well be healthcare’s music class: extraordinarily impressive, really quite beautiful in a way, but way off the measurement radar screen. If our students get the message that Goop's kind of clinical intelligence and diagnostic ability are unimportant (after all, they don’t seem to be part of what we’re calling “quality”), I think you can guess what will happen over time. Clinical "artists and musicians" will become extinct.