What’s next? Judging pediatricians on patient “growth”?

Judging pediatricians on the changes in the height and weight of their young patients as measured at their annual physicals from one year to the next makes just as much sense as using student “growth” on annual standardized reading and math tests to evaluate teachers.

But that’s just what the Chicago Public Schools will be doing beginning this fall, despite warnings from some 100 local education experts, who spoke out last week about the dangers of this evaluation model. Chicago Public Schools is rushing into a system in which test scores will soon account for up to 40% of a teacher’s job evaluation.

Here’s how that would look if we did it to doctors. You would bring your child in for her annual physical where she is measured and weighed. If she has grown faster than average, you’d pay the doctor more. If she is “behind schedule” or “below average,” you’d pay the doctor less, or perhaps you’d even “fire” your doctor.

The fact that “average weight” standards place half of all children below average wouldn’t matter.

The fact that your child’s size is more dependent on her genes wouldn’t matter.

The fact that your child’s rate of growth is also related to what you as parents are feeding her and how you are caring for her wouldn’t matter.

The fact that you might be jobless and dependent on aid to feed your child, and couldn’t always afford the most nutritious meals, or that you have been homeless and live in your car and can’t keep her warm enough so she always has a cold and loses her appetite, wouldn’t matter.

The fact that when you bring your child to the new doctor and he weighs and measures your child, she had a growth spurt and is now above average height and weight will not undo the firing of your previous doctor.

And the fact is, as every parent knows, your child’s height and weight tell you very little about the quality of medical care she is receiving.

Here’s how you tell if your child has a good pediatrician.

First, he is qualified, certified and licensed to practice.

Second, he is professional, runs an organized practice and takes adequate time with you and your child when you come in.

Third, he gathers a great deal of information about your child – not just height and weight. He watches your child walk to evaluate her bones and strength. He looks into your child’s eyes and ears to see what’s going on in there. He checks reflexes, asks you questions about your child’s habits, and, if there are any concerns, orders more tests to get more and better information as needed.

If wealthy “health reformers” and politicians successfully demanded that pediatricians be evaluated and paid based on a formula where a child’s growth in height and weight counted for up to 40%, we would probably find ourselves without a medical profession.

Besides, the whole thing sounds really stupid, doesn’t it?

Here’s what the National Academy of Sciences/National Research Council wrote in a 2009 report to Education Secretary Arne Duncan about value-added measures (VAM):

VAM estimates of teacher effectiveness that are based on data for a single class of students should not used to make operational decisions because such
estimates are far too unstable to be considered fair or reliable.

So why have we allowed people like Bill Gates and Michelle Rhee, astroturf groups like Stand for Children, and our state legislators to force such a stupid and potentially destructive system down the throats of one of our greatest national treasures, our teaching force?


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