DRAFT
New Conversations:Death over Dinner
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Saturday, July 12, 2014
In Praise of the Slippery Slope: The Hazards of Research Design for Provider Ratings
DRAFT In Praise of the Slippery Slope: test1
The Hazards of Research Design for Provider Rating
ABSTRACT: This article is intended to give a light touch to a serious topic--the use of customer satisfaction surveys in healthcare. While the motives may be honorable: to improve patient care and conserve expensive resources, depending upon surveys to rate and reward outstanding providers may lead to inadequate data, misleading analysis, and ultimately misinformed action. The consequences may be devastating to the genuine need for better healthcare. A familiar image used in the field of ethics, the slippery slope, is useful in this discussion because it suggests both risk and danger with the promise of desirable change from challenging and transforming the status quo. Engaging a slippery slope is most often discouraged since it leads toward one kind of disaster or another. We engage it here for many reasons. Personally, in my work in bioethics and information ethics, I've always been attracted to the slippery slope partially because it makes many ethicists uncomfortable. In addition, the slippery slope can lead us from academic arguments toward real world problems and rapid change. In the case of healthcare, the stakes are so high that I am eager to face criticism and the uncertainty of unleashing our imaginations.
Quantitative vs. Qualitative Research
Talking about research design in relation to quality ratings for healthcare providers makes me very uncomfortable. Those of us who favor qualitative over quantitative research live lives of quiet desperation in defending our research our theories and methods. Early on in our careers we learned that we would be disrespected in the competition for funding and journal placement. But we persevere, devoted to our belief that our methods come closer to bringing understanding more applicable to decision-making than approaches that measure undefinable variables that only seem to be meaningful for making comparisons. We have long ago let go of the notion that human experience can be explained and predictable. We know that to evaluate quality of care and provider impact is a very messy business.
Now pardon me if I'm overly sensitive, but it's hard to muck around in the swamps and deserts of human interactions and not be appreciated by peers and institutional authorities.
Social construction of reality
Social theory
Grounded theory
Hermeneutics
Social construction of reality
Social theory
Grounded theory
Hermeneutics
Hermeneutic of messinesss.
Hermeneutic of compassion
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