We’re All on Best Behavior When Others Are Watching

John A. Marcille

Senior Editor Mike Dalzell, author of this month’s cover story on the degree to which so-called “report cards” are being taken seriously, has a daughter in primary school. So does Frank Diamond, also a senior editor. They know about report cards.

“When my six-year-old daughter recently brought home her first real report card,” Frank told me, “I was ordered by someone close to both of us — you’ll never guess who — to make a fuss. Busy and distracted fathers sometimes need such encouragement to realize that while a ‘VG’ in social skills may look like two twenty-sixths of alphabet soup to us, it’s one of the most important things in the world to a first grader.”

Maybe more employers of the nation need such encouragement to review the “report cards” issued to health plans. As Mike’s story illustrates, only 6 percent of employers use HEDIS data, the gold standard of quality-of-care measurement. This apathy bodes ill — not only for employers and, down the line, their employees — but for those plans that are trying their best to do right as the National Committee for Quality Assurance gives them the light to see the right. (Apologies to Lincoln.)

Any good mother will tell you about the power of positive reinforcement. Any good coach will tell you about fear of failure. These lessons are as basic as the ABCs. Neither of these motivations can work as well as it should if no one is watching.

As the article so ably points out, the next time someone rails about lack of concern about quality, the anger might be best directed toward employers. Everybody needs encouragement.

Just ask any 6-year-old. Or physician. Everybody, it seems, wants to know how “good” his own doctor is. This may be why report cards focusing on them do get attention. Maybe too much attention, some physicians fear, in that it puts them right back where they don’t want to be: foot soldiers in a battle whose shots are being called from corporate offices.

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