DOCTORS AND TEACHERS MORE ALIKE THAN DIFFERENT

The Impact for Health and School Reform

By Dorothy Rich, Ed.D. - 8.28.09

It’s all very well to write policies for health and school reform. To carry these out, people have to do it.  For health care, it’s doctors. For school improvement, it’s teachers.

What has surprised me (more than I realized)  is how similar the situations of doctors and teachers have recently become and what this tells us about the prospects for real reform in health and schooling.   Both doctors and teachers are dependent for their success on factors well outside their control….well outside the control of the best intentioned policies.

Teaching and student learning; health care and better health are not linear relationships.    There are too many human variables that , up to now, have been uncontrollable.

All the expertise of the physician gets undermined when patients don’t follow through on medical advice such as don’t smoke, don’t eat too much salt. Many patients, even those with sufficient funds,  don’t fill and take  their prescriptions.

All the expertise of a teacher gets undermined when  children are poorly fed, left unsupervised at home , and come to school without encouragement from home to do their best.

There is an eagerness of patients and families  to forgive and forget their own personal responsibility for better health and stronger education.

We love doctors and teachers and we hate them.  We trust them and we don’t.  We want them to do it all for us. We want medicine and schooling to be the way it is on TV and in the movies,  easy and painless or violent and fast and in any case, unrealistic.

There is today more complexity and therefore more uncertainly and more choice about medical and school issues.

We know more about illness and about learning. There is often no one right answer.  We know more but are not so certain about who  has the expertise.  Both doctors and teachers today are less bossy – less the old-fashioned expert and dictator.

In general, we trust less.  A doctor used to say so or a teacher said so and that was the end of it.   We did not know better ,and now we do.  This is a real positive , but it makes  choices more difficult.

We expect our doctors and teachers to care about us and our families.   We don’t accept being treated badly – just because someone has a degree.

Doctors and teachers can both be judged on the toughest cases.  Teachers are concerned, if they teach in high poverty schools,  that they will be judged by how many of their students reach academic achievement goals.   Doctors who take on the hardest to treat cases fear judgment on how many of their patients make adequate progress to recovery when there may not be a realistic hope for recovery.

While similarities are strong, there are  key differences between doctors and teachers.  Both jobs wear people down,  The life and death  pressures on doctors are greater.  Doctors truly fear doing the wrong thing which can be irreversible.  Teachers can try to make up for the wrong thing by doing the right thing the next day.

Doctors make a mistake and  get blamed, really blamed, in the form of a lawsuit.  There are financial fears.  Doctors have them too, with reduced medical reimbursements and higher malpractice insurance costs.  Some people even think that teachers make too much money.     That is part of the love-hate relationship we have with  teachers and doctors.

Policies for reform in health and education are a starting point, but that’s what they are.  The big steps have to be taken by the people who have to follow through .

We need to be concerned about  the morale of our teachers and doctors.  They are  the front line human factors.   The public has to recognize its own major responsibility in  improving medicine and schooling. This is a team effort if  policies are to work.

 Good health takes more than a highly credentialed doctor.  Good schooling takes more than highly qualified teachers.  In both medicine and education, the public has assignments to follow after the diagnosis.  When these are overlooked, all the finest policies are Humpty Dumpties waiting to fall and fail.

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Dorothy Rich, Ed. D.is founder of the  nonprofit Home and School Institute and author of the MegaSkills books and training programs.

www.megaskills.org