Psychology and behavioral economics

I precipitated a recent online discussion about healthcare’s obsession with measurement (quality metrics is the current buzz phrase) when I quoted two aphorisms that highlight some problems with metrics and targets:

Goodhart's Law: "When a measure becomes a target, it ceases to be a good measure,"

Campbell's Law: "The more a metric is used, the more likely it is to "corrupt the process it is intended to monitor."

One comment rubbed me the wrong way because it implied that measurement reduces harm:

a total stranger one black day

(by edward estlin (e e ) cummings)

a total stranger one black day
knocked living the hell out of me-- 

who found forgiveness hard because
my(as it happened)self he was 

-but now that fiend and i are such
immortal friends the other's each.

Epictetus (AD 55 - 135) said: "You can't teach a man what he thinks he already knows."

This past year I became a certified Green Dot instructor. Let me tell you why it is important to me - and should be important to you.

After four decades in medicine, I retired from the active practice of primary care 15 months ago.  I still get asked at least once a day: “Well, how’s retirement treating you?” My usual reply is that it is a learning process. A more accurate response would be that it is like playing Tetris, but with pieces that change shape and rotate unpredictably as they fall.

(For those not of a certain age, here is Tetris: