141–150 of 274 posts
Earlier quoted context omitted.
The version I've heard might be a corollary: if you measure it, it will improve. The subtext is that the system won't improve; rather, something in the system will be sacrificed to improve the metric. The end result (usually quality) won't improve.
At best it probably only identifies the people to replace.
Earlier quoted context omitted.
I guess I'm just shocked that the surgeon could offer that level of assurance about something like that.
Unbelievable! The five year survival rate for lung cancer is only 18%! Even when the cancer is localized the five year survival rate is only 55%![1] It's irresponsible for the doctor to not give a reasonable prognosis! [1] http://www.lung.org/lung-health-and-diseases/lung-disease-lo...
What would you prefer? A surgeon who expects a poor outcome of your surgery: a)decides to not operate on you? b)decides to operate on you nonetheless? I am in camp a
It's Goodhart's Law in action, this time with deadly consequences: "When a measure becomes a target, it ceases to be a good measure."[a] [a] https://en.wikipedia.org/wiki/Goodhart%27s_law
Ironically applied to not-good hearts
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Sadly, it seems that your mother would not have had a better outcome with or without the surgery - if the doctor had said "I'm 75% sure that the cancer is contained in the one lung, so removing the lung will remove the cancer", would that have changed the decision to have the surgery? What it was was 50%? What is the threshold where someone with a fatal illness will accept the risk for a possible cure?
Perhaps the patient should have the right to decide what that threshold is for themselves rather than having the information hidden from them.
They left the decision in our hands, and in many ways that's not better - how on earth are we supposed to decide? They also can't tell you with any certainty what the after-effects will be because no-one knows.
It's Goodhart's Law in action, this time with deadly consequences: "When a measure becomes a target, it ceases to be a good measure."[a] [a] https://en.wikipedia.org/wiki/Goodhart%27s_law
I'm not so sure Goodhart's Law is correct. For example, if I target a high win percentage, is win percentage, then, not a good measure? Mortality rates are a pretty good measure for surgeons. The problem here is that they are inflating their measure by cherry picking. edit: Some measures should be targeted, the problem here is that it is done in an non genuine way
I disagree with the downvotes your comment's received.
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When I was fresh out of a school I worked in a call center for a while. One of the most important metrics (and everything you did was measured) was the average length of each call. So it was common practice, when you got cases that basically were going to be long calls or ones you probably couldn't actually resolve (e.g., "I want the service back on but cannot pay"), to deliberately upset the customers so that they w…
I'd also expect a bunch of "I'm going to transfer you... oops, pressed a wrong button and it hang up!" As a customer, I've had a fair measure of mysteriously hang up calls to support, I wonder how many of those are metrics-driven...
Of course some people would just say the issue was solved, falsely (which, you know, it was a little easier to get caught so it was higher-risk, in addition to being probably less moral), and there was also the X factor of how much you liked the customer, considering the extreme amount of verbal abuse the job entailed.
It's Goodhart's Law in action, this time with deadly consequences: "When a measure becomes a target, it ceases to be a good measure."[a] [a] https://en.wikipedia.org/wiki/Goodhart%27s_law
If I recall correctly, Munger considers incentives to be the single most important concept to properly understand in order to drive successful business (and arguably life) outcomes.
Not surprisingly, incentives are also chronically underestimated or outright ignored, even in situations where there's a strong, profit-driven incentive (#meta) to get them right.
> From all business, my favorite case on incentives is Federal Express. The heart and soul of their system – which creates the integrity of the product – is having all their airplanes come to one place in the middle of the night and shift all the packages from plane to plane. If there are delays, the whole operation can’t deliver a product full of integrity to Federal Express customers. And it was always screwed up. They could never get it done on time. They tried everything – moral suasion, threats, you name it. And nothing worked. Finally, somebody got the idea to pay all these people not so much an hour, but so much a shift and when it’s all done, they can all go home. Well, their problems cleared up overnight.
Check out the comments over on /r/medicine and you will likely be horrified. It is career over everything. There was even a thread this week about how you should NEVER correct someone above you (med students should never correct a resident and a resident should never correct an attending). That mentality is terrible for everyone and every thing, except the physicians' careers. I don't know if we need to select for be…