Baseball Forbids Pay for Performance – A Lesson for Healthcare?

Submitted by Steven Lewis on May 10, 2012 - 15:21

Baseball has terrific and comprehensive performance data to which it pays assiduous attention, and an outcomes-based culture. Yet its collective agreement forbids pay-for-performance (P4P) based on players' reaching certain statistical performance targets, like number of home runs or stolen bases. Health care ignores far more data than it pays attention to, yet P4P has been touted in many organizations as the solution to problems of quality and efficiency. This despite the dearth of comprehensive, valid data that relate what a provider does to how well her patients do. This post explains what baseball understands about P4P and why what seems to be a good idea in theory is fraught with unintended consequences in practice.

Do Clinicians Need Spring Training?

Submitted by Steven Lewis on December 6, 2011 - 18:29

Baseball has spring training and no one is exempt from the drills, the repetitions, the fine tuning, the repetition. It is not just a rite of spring; it is fundamental to the pursuit of excellence. Baseball assumes that skills are impermanent, mastery is fleeting, coaching is essential, and practice never ends. Health care assumes that skills once achieved are permanent, mastery comes with time, coaching is unnecessary, and practice is for students. Baseball has it right.

Coming to Terms with Performance Data: My Hero, Duke Snider, Was Not As Good As Mickey Mantle and Willie Mays

Submitted by Steven Lewis on October 18, 2011 - 06:45

Emotional attachments often lead people to overstate the ability and performance of people close to them. Duke Snider, the great Brooklyn Dodger center fielder, was my first sports hero. I thought he was the greatest. He was excellent, but he was only the third best center fielder in New York, after Mantle and Mays (or Mays and Mantle). Coming to grips with the incontrovertible statistical evidence on the relative performance of one's heroes is part of growing up. It's the same in health care: viewing performance through rose-tinted glasses can be harmful to one's health.