According to the NYTimes, Obama’s been reading the same NYer article I wrote about last week:
President Obama recently summoned aides to the Oval Office to discuss a magazine article investigating why the border town of McAllen, Tex., was the country’s most expensive place for health care. The article became required reading in the White House, with Mr. Obama even citing it at a meeting last week with two dozen Democratic senators.
Really people, read it if you haven’t already. It’s a great article. You can find the link in last week’s post.
So what can the eduworld learn from the health care world? How do we create incentives for more teachers to teach more students more effectively?
In the NYer piece Gawande discussed Minnesota, home of the Mayo Clinic, where Medicare spends less than half of what it pays in McAllen, TX–but where patients get better care. They replicated their model in Florida, and then in the town of Grand Junction, Colorado. How do they do it?
The core tenet of the Mayo Clinic is “The needs of the patient come first”—not the convenience of the doctors, not their revenues. The doctors and nurses, and even the janitors, sat in meetings almost weekly, working on ideas to make the service and the care better, not to get more money out of patients.
We’re obviously not trying to make money off our students (yet), but the translation to education has to be: THE NEEDS OF THE STUDENT COME FIRST! Not bureaucrats, not testing companies, not even teachers. It has to always be about the learning of the kids.
How does the Mayo Clinic Model do this?
But years ago the doctors agreed among themselves to a system that paid them a similar fee whether they saw Medicare, Medicaid, or private-insurance patients, so that there would be little incentive to cherry-pick patients. They also agreed, at the behest of the main health plan in town, an H.M.O., to meet regularly on small peer-review committees to go over their patient charts together. They focussed on rooting out problems like poor prevention practices, unnecessary back operations, and unusual hospital-complication rates. Problems went down. Quality went up. Then, in 2004, the doctors’ group and the local H.M.O. jointly created a regional information network—a community-wide electronic-record system that shared office notes, test results, and hospital data for patients across the area. Again, problems went down. Quality went up. And costs ended up lower than just about anywhere else in the United States.
They basically worked together, decided to take responsibility for preventing problems, remediating them as quickly and cheaply as possible, not spending tons of money on unnecessary things, and using technology to track and share information.
Doesn’t this sound so very scalable for education? For school sites and for districts?
And, if the Federal Government is looking for ways to incentivize this, they can also learn from the Mayo Model:
Mayo recognized that the first thing it needed to do was eliminate the financial barriers. It pooled all the money the doctors and the hospital system received and began paying everyone a salary, so that the doctors’ goal in patient care couldn’t be increasing their income. Mayo promoted leaders who focussed first on what was best for patients, and then on how to make this financially possible.
Instead of paying teachers to game the system and compete against one another, why not create an incentive that would be divvied amongst a pool of teachers? Encourage them to work together to find ways to reach all students effectively and be rewarded for sharing their ideas and taking responsibility. It could begin at grade-levels and then gradually expand to school site levels.
I think this would be much more effective than creating a star system amongst teachers where some were paid much more than others based primarily on test scores.
on Jun 8th, 2009 at 11:45 pm
Good idea!