Category Standardization

The Standardization Tax, Part 2: Why We Need Standardization

standardization can be an important tool to reduce errors

Before The Standardization Tax series argues against a certain kind of standardization, this post gives standardization its due. It opens with the true story of a five-step checklist Dr. Peter Pronovost developed at Johns Hopkins, which cut central-line infections in Michigan ICUs by 66 percent and saved thousands of lives. That success came from eliminating plain human error, not judgment. The post then turns personal: learning, during psychiatric training in the U.S., to ask every patient about alcohol and drug use as routine rather than a judgment call — and years later, watching another psychiatrist skip that same question during a mock board exam, for reasons which reflect the author's own earlier blind spot. The line is clear: variability in care can come from mistakes. And if standardization can eliminate those mistakes, then we should go for it.

The Standardization Tax: Not Every Tradeoff Is Worth It

continuity of care is a given in rural medicine

What would a pre-med student think if she heard how many doctors today say that they would steer their own kids away from medicine? They blame increasing corporatization, shrinking autonomy, and burgeoning documentation burden. These stem from increasing standardization in medicine. This post, the first in a series, introduces the idea that while standardization has benefits — catching errors, controlling costs, protecting clinician time — it also has a cost. Not all eliminated variation is waste.