David Cutler: belief

Transcript context

…You would hire a third party to assess how well your doctor had done? Because the literature is not mainly based on people with $100 billion, right? You’re designing something from scratch with extra resources. Yes, although there are metrics out there that you can certainly use. Most conditions — there are reasonable metrics that if you put them together, the docs are generally happy with. They’re not perfect. I think one could do pretty well by that. If you captured a lot of the doc’s attention — for example, the way that you do better — if you look at organizations that do really well, the way the organization does it is, they go to the doctor and they say, “This is what we’re going to practice here. We’re going to do images in this circumstance. We’re not going to do them in this. We’re going to do this in this circumstance. We’re not going to do it here.” Then, if the doctor says, “But that’s not the way I’ve been practicing,” you go to them, and you say, “Look, here’s the literature. Here’s the stack of articles that shows that this way is best. Now, go ahead and read through them. If you want to talk about them, and you don’t believe they’re right, let’s absolutely have that conversation. But until we agree that there’s something better, this is how we’re going to practice. ” It’s like the whole organization is invested in doing the right thing, and then it sets up its systems and processes so that it’s all geared towards the right thing. As you probably know, from 1950 to 1990, American youth suicide rates tripled. Why did that happen? And they’ve gone up since then at various times.…

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