The Rising Tide

Often, you’ll see healthcare organizations single out their most productive providers and hold them up as examples for everyone else to follow. That makes a certain amount of sense. After all, we can always learn from each other, and there are certain best practices that we can spread around in a way that benefits everyone. But sometimes, this praise of the highly productive providers is mixed with an implied criticism of the less productive ones. 

“If only the rest of you performed like our superstars, we’d be just fine.”

The implication is that, somehow, we could take the full range of performance and contract it to a narrow band around the highest point in the range. We should transform the bell curve on our graph, so the thinking goes, into a single, high-performing vertical line.

That’s a pipe dream. Variation can be reduced, but it can’t be eliminated. There will always be differences in practice style, panel size, patient demographics, staff support and expertise. And productivity, when viewed in isolation,  is a terrible measure of success. It’s easy to see more patients by sacrificing patient satisfaction, provider sanity and quality of care. 

Significant, sustainable, widespread improvement in performance is never accomplished by tweaking individual provider practices. It requires systemic changes on a large scale. The rising tide lifts all vessels--dinghies and luxury yachts alike.