I was getting my internet connection fixed and a technician had to come out. He thought that the hardware needed to be swapped for a newer version, but before taking that somewhat drastic step, he decided to call central technical support and see if they could reset things. They tried, it still didn't work, and … Continue reading Don’t let a good mistake go to waste
I did two things last week which at first seemed unrelated. First, I finished reading the book The Checklist Manifesto by Atul Gawande. Second, I attended a roundtable discussion on the topic of utilization management, with a focus on the history and use of pre-authorization. In The Checklist Manifesto, Gawande describes his quest to increase … Continue reading How do we manifest the checklist?
A police officer arrests the same person dozens of times in order to make an arrest quota. A bank employee opens accounts for customers without their permission because of a cross selling incentive. A teacher helps students cheat in order to improve tests scores so that the school will receive more funding. What's happening in … Continue reading Metrics as judgments
Even well intentioned leaders can sometimes use questions that break down a team rather than build it up. One of these question types I call the trap, and the other is the treasure hunt. The trap works like this. You ask someone a question, expecting that they will get it wrong, so that you can say … Continue reading The trap and the treasure hunt
In the movie The Terminator, Reese, the bodyguard from the future, talks about how the machines took over: "Defense network computers. New... powerful... hooked into everything, trusted to run it all. They say it got smart, a new order of intelligence. Then it saw all people as a threat, not just the ones on the … Continue reading The Problem with Terminators
A colleague and I were discussing a project to try to coordinate the cooperation of several radiologists who currently work in silos. I asked him what main problem we were trying to solve. He said that the main issue was the lack of fairness: some radiologists read more studies than others. I can understand where … Continue reading Goals and Guardrails
You are making dinner for a few friends. The plan is for spaghetti, but you forgot to buy the sauce and now you're out of time. But hey, it's still free noodles. And you went to all the work to plan it, so they should be grateful, right? You manage a hotel that is offering … Continue reading Is some better than none?