A Teaching Analogy

This is an email I received and tweaked to fit my own personal style. The point it makes is still valid. Enjoy.

No Dentist Left Behind

My dentist is great! He sends reminders so I don't forget checkups and uses the latest techniques based on research. He never hurts me and I've got all my teeth.

"Did you hear about the new state program to measure effectiveness of dentists with their youngest patients?" I asked.

"No," he said. "How will they do that?"

"They will count the number of cavities each patient has at age 10, 14, and 18 and average that number to determine a dentist's rating. Dentists will be rated excellent, good, average, below average, and unsatisfactory so parents will determine which are best. Less effective dentists can improve. Poor dentists who don't improve could lose their licenses."

"That's terrible," he said. "Dentists don't all work with the same clientele and much depends on things we can't control. I work in a rural area with patients from deprived homes, while some of my colleagues work in upper middle-class neighborhoods. Many parents don't bring their children to see me until there's a problem. I don't get to do much preventive work. These parents let their kids eat too much candy, unlike educated parents who understand the relationship between sugar and decay. Many of my clients have well water which is untreated and without fluoride. Do you have any idea how much difference early fluoride use can make?"

"You're making excuses," I said. "You needn't fear accountability."

"I am not being defensive!" he said. "My best patients are as good as anyone's, my work is as good as anyone's, but my average cavity count is going to be higher because I chose to work where I am needed most."

"Don't get touchy," I said.

"Touchy?" he said. "I will be rated average, below average, or worse. The few educated patients I have may believe this so-called rating and leave me with only the most needy patients and my cavity average score will get worse. On top of that, how will I attract good hygienists and dentists if I'm labeled below average?"

"I think you are overreacting," I said. "'Complaints, excuses and stonewalling won't improve dental health'...I am quoting the DOC."

"What's the DOC?" he asked.

"Dental Oversight Committee," I said, "a group made up of mostly lay persons to make sure dentistry improves."

"Reasonable people won't buy it," he said hopefully.

"How else would you measure good dentistry?"

"Come watch me work," he said. "Observe my processes."

"That's too complicated, expensive and time-consuming," I said. "Cavities are the bottom line and you can't argue with the bottom line. It's an absolute measure. The state will help you some. If you receive a poor rating, they'll send a dentist who is rated excellent to help straighten you out."

He shook his head.

"Doing this would be like grading schools and teachers based on children's progress with no regard to the home or community served. Why would they do something so unfair to dentists? No one would ever think of doing that to teachers."