The Conundrum of Blaming Teachers and Doctors: Second Time Around

I published this post over two years ago about blaming teachers and doctors for institutional low performance.  Both teachers and doctors are blamed for the problem, on the one hand, yet, on the other hand–give thanks that we only have two hands–they are expected to solve the very problems for which they are blamed. The conundrum is still alive and breathing in 2011.

Has anyone noticed that much of the blame showered on teachers and unions for blocking school reform by business-admiring pundits and policymakers is usually followed by perky pay-for-performance plans and other solutions wholly dependent upon teachers embracing the changes? Framing teachers as both the problem and the solution is a tough conundrum to unravel. Teachers, however, are not the only ones to grapple with the paradox of being blamed for a problem and then expected to turn around and solve the very same problem.

Consider medical care. Patients, insurance companies, and federal officials criticize physicians and hospitals for errors in practice and ignoring the accelerating cost of providing health care. Tough questions are asked: Which hospitals are best and worst for cardiac surgery or for treating children with cystic fibrosis? Why do doctors commit many errors (illegible handwriting on prescriptions, incomplete charts, etc.)? Should doctors get paid for how often they treat patients or how well they treat them?

In an era of rising health care costs, voter reluctance to increase taxes, holding doctors publicly and personally responsible for outcomes and containing costs have spurred market driven reforms that have swept over the practice of medicine heretofore immune to such debates. For-profit hospitals and private insurers now compete for customers, magazines publish rankings of best U.S. hospitals, and insurance companies link doctors’ practices to their pay. Such instances of business-inspired reforms seek improved delivery of health care to Americans.

These market-driven solutions for health care problems—let’s call them reforms–raise serious issues of trust between doctors and patients over the degree to which private insurance companies or physicians will control medical practice. Deep concerns over doctor-patient relationships and practitioner autonomy get entangled in volatile policy debates over the quality and cost of national health care thus sharply spotlighting the contradiction of more than 800,000 doctors and nearly 6,000 hospitals getting singled out as being a serious problem while looking to these very same people and institutions to remedy the health care crisis.

Teachers in largely minority urban and rural schools have been framed as both the problem and solution for low-performing students. Expanding parental choice through charter schools, advocating higher pay for administrators and teachers who can show student gains in test scores, promoting more competition among schools are only a few of the packaged ideas borrowed from the business community. This shared paradox among medical and school practitioners of being bashed and then expected to solve the problems for which they are bashed is like a virus that has infected two social institutions critical to the nation’s future. No vaccine, however, exists for this virus. The conundrum is here to stay.

What to do about this abiding paradox?

1. Were national and state leaders to openly acknowledge that blaming teachers as a group for the ills of poor schooling and then expecting those very same awful teachers to turn around and work their hearts out to remedy those ills is simply goofy. Over 3.5 million teachers do the daily work of teaching; they teach reading, wipe noses, find lost backpacks, write recommendations, and grade tests. No online courses, charter schools, vouchers, home schooling, or any other star-crossed idea that business-driven, entrepreneurial reformers design will replace them. So blaming and shaming teachers into working harder is no recipe for improved student learning. Surely, like any group of professionals, teachers have to be prodded and they have to be supported. Prodding they get a lot of; support is where these so-called leaders fall down badly.

2. De-escalating the virulent rhetoric about unions and incompetent teachers would be a reasonable first step. Lowering the noise level from 24/7 cable, the Internet, and talk radio is as hard to do as it is to get bipartisan support among Republicans and Democrats over health care reform in a polarized political climate. Respect for teachers, never high in the U.S. to begin with, has unraveled even further with constant bashing. But hard as it is to ratchet down the noise level does not mean it is impossible.

3. Moving away from critics’ obsessive concentration on unions and the small number of incompetent teachers (or “rubber room” examples of non-working but paid teachers in New York City) and focus on the structures that keep even mediocre teachers from improving is another step. Such structures as single-salary schedule, evaluation procedures, hit-and-miss professional development, daily load of students to teach, number of courses taught, and the age-graded school—all influence what happens in classrooms.

None of these in of themselves can end the conundrum of blaming teachers for untoward student outcomes and then depending on them to fix the problem. But they are a start.

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1 Comment

Filed under comparing medicine and education, Reforming schools

One response to “The Conundrum of Blaming Teachers and Doctors: Second Time Around

  1. larrycuban

    The following comment came to me in an email from Bob Calder. He gave me permission to use it in the Comment section. Bob raises some important issues and questions:

    Larry,

    I would like to suggest that history has a story to tell us about how
    hospitals and insurors got entangled.

    Around 1900 healthcare began to become institutionalized as it moved
    piecemeal from the doctor’s home to his office, thence to a hospital
    where critical care was delivered. As the wars improved critical care
    and surgery from palliative to intervention-based cure, cost became a
    factor. Hospitals concentrated critical care and cost and physicians
    that delivered critical care became a powerful force.

    Insurance companies were not in the health business until an agreement
    between a teacher’s union and a hospital required financing and the
    Blue Cross was created out of this need in 1929. (
    https://eh.net/encyclopedia/article/thomasson.insurance.health.us )

    Insurance is a financing tool and as such is bound to the institution
    of the hospital. If finance were not necessary, insurance wouldn’t be
    necessary. I don’t know what this can tell us about education.

    How about the role of consultants in both ed and health? I wonder how
    the changes brought about by consultants impacted both industries? The
    friction between health insurors and hospitals is a source of capital
    for consultants as they work one against the other seeking profit. Is
    there an analog in education? Perhaps measuring the effect strength
    might demonstrate something interesting. Perhaps what has been
    happening is that consultants/movements to improve constantly ratchet
    up cost resulting in little or no improvement. The fact that one is
    governmental and the other is business may be irrelevant.

    I’m cc-ing Glen because he watches some of the interactions in
    Tallahassee and may have seen something that can shed light.

    Happy Thanksgiving!

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