Friday, January 25, 2013

Electronic Medical Records Encourage Fraud?

Unfortunately, this is all too believable.  With a paper record, it's all too obvious if someone “pastes” in a template (though I've actually seen this done in a few of my own medical records).  With an electronic record, at least with current technology, there's no way to detect this.  I share Megan McArdle's angst about this.

I have no doubt that this is an unintended consequence of Obama's electronic medical record mandate, just as I also have no doubt that there are good consequences of having them.  However, it also seems like something that could have been shaken out in a more orderly, market-driven rollout.  Mandates such as this have another unintended effect: the motivation of the vendors is no longer function and quality driven (as a competitive marketplace would drive); instead it's focused on delivering a product that meets the minimum mandated requirements as quickly as possible.  The “first mover advantage” in such situations completely outweighs any normal competitive issues.  Result: you get a product that looks exactly like what it is – a designed-by-government-committee mess.

Our country is in the very best of hands...

More Awesome People...

Women in Combat...

My quote of the day is from a reader and friend, Larry E. (a Marine, but not on active duty), who said in an email to me:
This has been done before in other militaries and the end result was always reducing standards for women. The flaw here is that the goal really isn’t just to open up positions to women, it is to get women in those positions. A subtle but important difference.
Yup, that's exactly what I"m afraid of.

Yesterday's news was full of stories about our military leadership assuring us that there would no lowering of standards, and no double standards (one for men, one for women). They're saying loudly and clearly that our current military standards will have to be met by women if they want the role.

Bet that doesn't last long.

Here's Larry's entire email:
I took some interest in the announcement because it was a frequent topic of conversation when I was in the Marines in the 80s.

And even way back when I was in the Marines we would complain that women would get promoted just as fast as men, but had a lesser physical fitness standard. Call it military affirmative action. Much has changed over time, for example, back then women were given classes on harmonizing their lipstick with their cap-cord so you can imagine our.. consternation at this. Today the training for women is much closer to their male counterparts but it remains that their physical fitness standards are less stringent. If they were not, there would be very, very few women in the Marines.

In this case, the impetus seems to be that it is difficult for officers to make it to higher ranks without combat experience. In fact, officers that are destined for higher things tend to move around a lot as they gain some experience in a variety of positions. Logistics, combat units, garrison units etc. I’m not surprised at all there are fewer women general officers. There are fewer women in the military overall, until the last few decades the positions they filled were severely limited with only the last decade or two opening things up significantly.

Each military service has specific standards, physical and mental, that are required. Each job in each service has varying standards in addition to the minimum. You take a placement test before joining, and during your training, you must meet certain minimum physical and mental standards to pass or you will find yourself either out of that service or moved to a different job. We were always threatened with cook school if we couldn’t pass.

Combat Infantry is no different. There are very demanding physical needs that are beyond the physical requirements for say, computer programmers. And while we say in the Marines that every Marine is a Marine Rifleman first, and the standards in general are quite high, the reality is also that while each had to meet minimum physical standards, Combat Infantry has to meet more rigorous physical standards and even within there, if you are a big hulking guy, you will be carrying the mortar base plate while someone else carries the machine gun.

So you’d think the solution is simple, ensure that the minimum standards for each job is set appropriately. If it requires carrying an 80 pound combat load 20 miles, then there is your additional standard. If it requires doing complex math test for it, if you need eye hand coordination (video games) to fly drones, then that is your standard.

Unfortunately this doesn’t really work.

This has been done before in other militaries and the end result was always reducing standards for women. The flaw here is that the goal really isn’t just to open up positions to women, it is to get women in those positions. A subtle but important difference. Initially they just open up the positions for women if they can meet the standards for that job. Reasonable and fair. Then they find out that perhaps only 1 woman out of thousands can actually meet the standards for certain positions and zero for others and so they are embarrassed that their policy doesn’t work. The standards are questioned relentlessly and eventually adjusted until they do get women in those positions.

So where does it leave us?

I agree that the positions should be open to anyone capable. Frankly it is the only right thing to do. But the end result is also clear. We will have people in some positions that are far less qualified for them. For the most part, it will be women officers ticking a box on their career sheet before moving on. Leading a combat infantry platoon perhaps. Her men will either make fun of her for lacking the ability or be impressed she can hang at all and the Sergeants will keep things moving along. Not much different than its always been really.

Don't Like Your Job?

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That's It - the Internet is Finished!

Beautiful Butterfly...

From a collection of images my mom sent me:

Dogs and Trampolines...

My mom sent me a video of a dog playing around on a trampoline, which I thought was pretty cool.  I went onto YouTube and searched for it in an embeddable format, and found it – along with dozens of others.  I had never heard of dogs enjoying a trampoline before!  That same search I linked will also lead you to videos of cats, foxes, and even skunks on trampolines...