Alive 75: If physicians were held to the same standard as schools

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Adequate yearly diddily poop, part 2: “Alive 75”

No Child Left Behind mandates that all students be “proficient” (another term worthy of examination) in core subject areas by 2014. Kansas defines proficiency as “meeting or exceeding” the curricular standards for a subject area and grade level. Using the first assessments as a baseline for student performance, AYP is the amount by which student scores must increase each year such that 100% of students are proficient by 2014. If students’ scores don’t increase by that amount, the school is labeled “failing”.

It isn’t just the school’s overall scores that must meet AYP, but also sub-groups of students within the school. Students with learning disabilities, English language learners, and students in poverty must all meet AYP independently of the school overall. It is often these disaggregated scores that cause entire schools to fail AYP.

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Consider a national requirement placed on physicians: by the year 2014, 100% of patients must live to the average life expectancy, roughly 75 years of age or older. Then, each medical practice will be evaluated based on whether or not their patients’ survival rate improves enough year-to-year to reach “100% alive at 75” by 2014.

“Alive 75” has a nice ring to it, and should sell well; like “No Child Left Behind”. Instead of adequate yearly progress (AYP), Alive 75 could set an “Annual Survival Standard”. Just as NCLB makes no distinction among special education teachers, remedial teachers, and advanced placement teachers; Alive 75 can make no distinction among medical specialties. All doctors, from family practitioners to pediatric oncologists and palliative care physicians, must be held to the same Annual Survival Standard.

And as NCLB makes no distinction among schools in affluent suburbs, rural communities, or inner-city slums, Alive 75 can make no geographic distinctions among medical practices. Clinics in Burlington, Vermont must meet the same Annual Survival Standard as those neighboring Rocky Flats in Denver, Colorado. In order for Alive 75 to mirror public education, no medical practice can turn unhealthy or uncooperative patients away – they must accept all who live in their community. In fact, just as schools are accountable for test scores of the chronically truant, doctors must be accountable for the longevity of people they never see.

And just as schools are accountable for every new student who moves into the neighborhood, each medical practice is 100% responsible for new patients’ life spans. The quality of medical care, or lack thereof, the patient received earlier in life is irrelevant – only the current medical practice is held accountable. Finally, Alive 75 must disaggregate the data for important sub-groups: patients with genetic disorders, cancers, and life-threatening traumas, for example, must meet the Annual Survival Standard independently of the total patient population.

more here: http://www.examiner.com/examiner/x-29491-Topeka-K12-Examiner~y2010m4d8-Adequate-yearly-diddily-poop-part-2-Alive-75