If Schools Were Hospitals

If Schools Were Hospitals
by Kymberlee Ricke
written July 12, 2010


So, "merit pay" is one of those words being bandied about in education more and more lately as districts look for a way to eliminate tenure and find ways to fire teachers on the higher end of the salary scale.

Now, I'm not saying bad teachers should be retained. That would just be stupid. But there's such a huge difference between a 'bad teacher' and a teacher in a difficult teaching situation.

So let's think of it like this: Medical Professionals, you are now on merit pay. If your patient gets 100% better, gets to perfect health, you will get a bonus.

But if your patient dies, you will get docked and you will be put on probation. Now, sure, there's always one who spoils the numbers, so we'll track your patients for a year and take an average. If 70% or more of your patients are as healthy or healthier than they were before they got whatever it was they came in to see you for, you'll get a bonus. If you're under 50%, expect to be fired. And it doesn't matter *why* they're less healthy at the end of the year, just that they are. If they came to you for asthma treatments and got so healthy that they went running and got hit by a car [lost a parent or had another trauma]? Hey, they were your patient and all we care about is the test results we can get from them at the end of the year.

Geriatrics [economically depressed area schools - especially high schools], we know you're screwed, sorry about that. We get that you're getting people who are reaching the end of the line and you really don't have a lot of time to deal with the possible mistakes made in the past and really if your patient dies [drops out] there isn't much you could do, but we're still figuring your numbers the same way as everyone else. So if you're really talented, you may want to think about taking your talents to another area. Yeah, that leaves the 'less than the best' trying to do that really difficult job, but if you're that good, why would you want to jeopardize your career in such a risky area?

On the other hand, Obstetrics [gifted programs], you're in great shape! You get people coming in who have, for the most part, been getting great medical care for 9 months and have taken pains to improve bad health habits. And if you do everything right, you'll have *two* healthy patients on your service a year from now. And if things go really badly, you can hand off at least one of them to neonatal [regular ed.] Which means that person is off your service and no longer part of your statistical group.

Cosmetic Surgery? [Transfer Students] You need to be really careful because when they come in, there's absolutely nothing wrong with them, but when they leave the hospital they'll have bruises and stitches and staples [spend at least two weeks trying to adjust and catch up to the different curriculum], so be damn sure that your perfect patient is even more perfect a year later or you'll hear, for the rest of your life, "This is all your fault, this was fine before you cut into me. [at the last school]."

ICU [Special Ed], we'll cut you some slack. We understand that by the time they've come to you that things are pretty bad for reasons outside your control. But they should get *better*. They may never get to 'perfectly healthy', but dying is not acceptable and will be held against you regardless of the condition they came to you in.

And just in case there was a question, we're going to hold all hospitals to the same standard. It doesn't matter if you're at Cook County General (public hospital that must take all patients, regardless of ability to pay) or the Mayo Clinic/Johns Hopkins/UCLA. It doesn't matter if your facility has the money to give full body scans [individualized testing/programs] to every person who comes through the doors or if you're hoping you don't run out of band-aids [pencils] before Friday. It doesn't matter if you have the kind of program people apply for and fight to get into and therefor follow the protocol to the letter [parents that give a damn] or one where we throw you eight or twelve critical patients at a time, half of whom won't get the meds/do the follow-up care if they do make it out the door [parents who don't care].

So at the end of the year we're going to round up every patient you've seen - possibly including those you only 'saw' as you passed them in the waiting room [students who transfer in and out again, but happen to be with you for state testing] - and give them all the same battery of tests. The first test will be to see if they can walk into the exam room [read]. If they can't walk in, they can't even have the rest of the tests. Wait, what about that person who uses a wheel chair and didn't come to you about walking-related issues in the first place? Yeah, that's rough for you but everyone should be able to walk, shouldn't they? You should have done something about that. Nevermind that no one did anything about it for the first 10/20/30 years of his life, or even that there was nothing *to* be done. And just because you did a great job making sure his swine flu was cured [he could do math], if he can't walk into the exam we'll never get to the part where we check to see if his heart is beating or his skin is clear or if in fact, he made it through the swine flu with flying colors.

So yeah... let's put the whole world on 'merit pay'. This will certainly make sure everyone can walk, have clear skin and survive the swine flu. There's no reason at all to take into account individuals, economic situations or political climate.