4 ms·

Hospital Kept Vegetative Patient on Life Support to Boost Survival Rates

38 points by danso 7y ago

enjoyitasus 7y ago
Isn't this the perfect case of having the wrong incentives?!
pvaldes 7y ago
So, basically, everybody wins
alexfromapex 7y ago
This is why healthcare is broken. I’ve also heard that hospitals can lose accreditation for having bad outcomes and will turn away risky patients which is just as horrible.
- noir_lord 7y ago
  Healthcare in the US certainly. I mean other health care systems have various problems but when the profit-motive (in the form of the hospital administration) clashes with the medical side, we know which one usually wins.
abdullahkhalids 7y ago
This is classic Goodhart's law [1]. Humans or systems of humans will automatically game any metric that is used to measure them. Whenever you start using a number of measure performance, people start to forget about ethics. This is also happening in university education these days where professor's performance is being measured by metrics that only roughly correlate to teaching ability. So, profs spend more time ensuring their metrics don't fall below the acceptable value than they do trying to improve their teaching performance. In other words, introducing these bad metrics to somehow measure and improve teaching performance, actually results in worse teaching performance. [1] "When a measure becomes a target, it ceases to be a good measure." or "when a feature of the economy is picked as an indicator of the economy, then it inexorably ceases to function as that indicator because people start to game it." https://en.wikipedia.org/wiki/Goodhart%27s_law https://en.wikipedia.org/wiki/Goodhart%27s_law
- lathiat 7y ago
  I had previously heard about similar problems with surgeons not wanting to dent their "mortality" rate by refusing to operate on cases that were in some way likely to result in death. Obviously this results in worse outcomes for those patients either by requiring a less experienced surgeon or possibly not being operated on at all. Can't immediately find a citation.

38 points by danso 7y ago

enjoyitasus 7y ago

Isn't this the perfect case of having the wrong incentives?!

pvaldes 7y ago

So, basically, everybody wins

alexfromapex 7y ago

This is why healthcare is broken. I’ve also heard that hospitals can lose accreditation for having bad outcomes and will turn away risky patients which is just as horrible.

noir_lord 7y ago
Healthcare in the US certainly. I mean other health care systems have various problems but when the profit-motive (in the form of the hospital administration) clashes with the medical side, we know which one usually wins.

abdullahkhalids 7y ago

This is classic Goodhart's law [1]. Humans or systems of humans will automatically game any metric that is used to measure them. Whenever you start using a number of measure performance, people start to forget about ethics. This is also happening in university education these days where professor's performance is being measured by metrics that only roughly correlate to teaching ability. So, profs spend more time ensuring their metrics don't fall below the acceptable value than they do trying to improve their teaching performance. In other words, introducing these bad metrics to somehow measure and improve teaching performance, actually results in worse teaching performance. [1] "When a measure becomes a target, it ceases to be a good measure." or "when a feature of the economy is picked as an indicator of the economy, then it inexorably ceases to function as that indicator because people start to game it." https://en.wikipedia.org/wiki/Goodhart%27s_law https://en.wikipedia.org/wiki/Goodhart%27s_law

lathiat 7y ago
I had previously heard about similar problems with surgeons not wanting to dent their "mortality" rate by refusing to operate on cases that were in some way likely to result in death. Obviously this results in worse outcomes for those patients either by requiring a less experienced surgeon or possibly not being operated on at all. Can't immediately find a citation.