Monday, September 03, 2012

Devil In The Details

I loved the idea of a three year tour of duty in the military. You got three years in a job to make a difference and then before you institutionalized yourself, you had to pack up and go someplace else to face a new challenge. It is an effective model.

But, no system is perfect. The rotational model also harbors the change-for-its-own-sake problem. You have to make an impression, so you add a layer of supervision, revise a record format, impose a new requirement or institute a secondary group of inspections. No net gain in productivity or mission accomplishment, but you did something and it could be noted on the performance report. Attaboy!

I watch SWMBO in her daily dealings with the speech therapy administration in public schools. We get the federal bureaucracy adding requirements in forms, reports, condition coding, status statements, mandatory meetings, follow-up validations, etc. Eventually it leads to all bureaucracy all the time...and no time for actual therapy for students.

Here we've got Sen. Bill Frist, M.D. looking at the panacea which the no-nothings of Congress insist will cut healthcare costs and improve services while not costing providers a bit of inconvenience or compensation. Logically enough, the solution is much worse than the cure:

So You Think You Get Well Through Paperwork?

Doctors work hard to heal patients. Patients want care, not a detailed record of why they succumbed to their ailments. Why can't Congress figure that out?


David U. said...

Ed, you SOB!

I was visiting the Frontiers of Flight museum last week, admiring the Thud parked outside. After taking my son through the exhibits, he forced me to visit the museum store. I was just about to checkout, when, on a table next to the cash register, I saw a paperback copy of your Thud book.

I only bought it because it was signed, mind you.

Well, I started reading it last Sunday night, couldn't put it down and stayed up all night reading it. My performance at work on Monday was so bad that I probably will lose my job. Thanks for nothing!

David U

Chris Manno said...


If you haven't been fired yet for reading "When Thunder Rolled," pick up "Palace Cobra" which you also won't be able to put down (I rationed it because I didn't want it to end) and you'll definitely get fired.

Far be it from me to ruin your career, but Ed discusses the books on my podcast, another way for you to do something fun that has nothing to do with your job.

While you're at it, check out "Fighter Pilot" which Ed co-wrote with Christine Olds and her famous father's huge collection of papers and personal accounts.