Goodhart's Law and Patient Satisfaction
When a measure becomes a target, it ceases to be a good measure
This is a quick hit — a focused idea to make you think. Let me know if you like the short format. As always, comments are appreciated. Welcome to new subscribers who came through the Doximity email blast — almost broke the server!
Goodhart’s law suggests that when a measure becomes a target, it ceases to be a good measure. When I first read this I couldn’t help but think of healthcare and the quest for the perfect patient satisfaction score.
The problem with this quest is that as soon as we steer physician behavior and teach to the test, patient satisfaction scores stop being a valid measure. Essentially, the metric becomes a proxy for ability. High patient satisfaction scores more likely mean that we’re good at getting high patient satisfaction scores. And most major hospital systems and health professionals have found a way to get good at the metrics.
What’s worse is that when we obsess about the measure we wind up with a hospital full of doctors who strangely lean forward.
Richard Fisher in MIT Technology Review characterized this kind of thinking as short-termism: To escape short-termism, we must reassess the targets by which we gauge success. Do they encourage longer-term thinking, or do they prioritize only present-day gains?
Satisfaction of our patients should be a top priority. But we need to find a way to get beyond the short-term pursuit of percentages and numbers.
Photo by Count Chris on Unsplash
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YES, I like the short-form format! thanks for the food-for-thought on where patient satisfaction scores fit into the delivery & experience of healthcare.