Goodhart’s law and patient satisfaction

Goodhart’s law suggests that when a measure becomes a target, it ceases to be a good measure. When I first read this I couldn’t help but think of healthcare and the quest for the perfect patient satisfaction score.

The problem is that as soon as we steer physician behavior and teach to the test, patient satisfaction scores stop being a valid measure. Essentially, the metric becomes a proxy for ability. High patient satisfaction scores more likely mean that we’re good at getting high patient satisfaction scores.

What’s worse is that when we obsess about the measure we wind up with a hospital full of doctors who strangely lean forward. 

Richard Fisher in MIT Technology Review characterized this kind of thinking as short-termism: To escape short-termism, we must reassess the targets by which we gauge success. Do they encourage longer-term thinking, or do they prioritize only present-day gains?

We need a better measure of patient satisfaction. 

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Slightly modified image via Alexander Sinn on Unsplash.