"One For All"

01/12/2009 05:12 am ET | Updated Nov 17, 2011

When we treat similar people by different rules, like paying a woman differently from a man for doing the exact same work, that is called a double standard and we all resent it.

What about a triple standard? Shouldn't we resent that even more?

Healthcare providers are judged by a standard of patient outcomes. Managers are judged by a completely different standard - costs. And regulators...they are not judged at all (no standard). But, the outcomes that patients experience result from decisions made by all three groups. Thus, doctors, managers, and regulators are judged by three different sets of rules: a triple standard.

You expect your doctor to practice evidence-based decision-making. Why not the managers and regulators? They affect you at least as much as the doctors! Why do they get away with this? Answer: the triple standard.


There are many different mechanisms for feedback to the care providers, such as utilization review; professional standards; and, when the patient is harmed, the medical malpractice system. What feedback occurs TO managers or regulators when a patient is injured by their decisions? Answer: none. Only the providers get feedback. Only the providers are held accountable. Triple standard again. Remember: only those who get feedback learn.

Do you want to begin curing healthcare? Start by demanding a single standard - "One for All" - one set of rules for all people who determine our health care.