And I realize that I have oversimplified a lot of what goes on in the medical profession.

However, I still can’t help put think that doctors and nurses learn from cases (or their experience). For instance, today our daughter’s doctor said that she has seen two cases in her career where the child looked well, but did have a serious infection. This doctor is a seasoned professional and her personal experience helped her make a medical decision regarding my daughter.

I am only advocating for more opportunities for this type of knowledge acquisition to be part of the modern medical processes. I bet there are lots of people out there working on this problem, and I know there are lots of great medical professionals that go out of their way to follow up on their patients. I would just like to see more opportunities for this to happen.

It grows out of the concept of a profession. Within a profession, certification is granted by other people in the profession. This is a necessary and important component of preserving and advancing knowledge in disciplines, but it also has the tendency to close down communication channels from those outside the profession.

To be clear, I am not addressing issues of patient satisfaction, I am thinking about ways for a doctor/nurse to easily see the repercussions of their recommendations.

I think medical professionals need more than individual feedback for their clinical performance. I’m not sure if there is value in that or not. You’d have to ask them. Medicine, though some art, has really move towards science and being evidenced-based through randomized clinical trials, etc. I think more valuable are systems to roll-up performance and outcomes data so they can see their own aggregate results, trends, comparisons to others, etc. There are starting to be systems that do this and provide patient sickness severity-adjusted reporting down to the physician or health-care worker level so they can adjust their behavior for particular disease pathways to improve care.

The reason that feedback helps a barista and hurts a physician is that the value of a barista’s product is directly correlated to customer satisfaction. It could be argued that a large component of health is mental, and I do think that mental health professionals should have a feedback mechanism, but a physician’s quality assurance should be based on advances in scientific study and not on a drive to increase the number of “strongly agree”s on a survey. There’s a name for that: faith healer.

1) it takes time to care
2) it uncovers your weaknesses

Asking for feedback requires an honest desire to get it, and enough confidence to process it appropriately.

Solid.

Although, there is probably a vast difference in feedback between a healthy person, who just gets sick once, and someone with a chronic illness who seems the doctor more often.

There is an interesting article (about basketball, no less) in this weeks Times Magazine that I think makes a good analogy: http://www.nytimes.com/2009/02/15/magazine/15Battier-t.html?_r=1&ref=magazine Good article regardless of your interest in sports.

Also, if you’re not aware of Quality Improvement, it might be of interest. It’s essentially a continuous improvement feedback cycle using patient data, although it’s far from the direct feedback you are talking about. Unfortunately, user adoption is pretty low compared to typical continuing medical education, at least in our experience of administering online CME. I wonder if the patient couldn’t become a participant in this. Seems like that would be useful, especially when taken in aggregate across thousands of docs. Hmmm….