Gawande, ?The Bell Curve?

Discussion questions: Gawande, "The Bell Curve (first publ. 2004)

1. This essay alternates between discussing CF treatment and discussing more general points about the bell curve, Berwick's push to "measure ourselves and be more open" about the results, and the possible results for patients and doctors of such openness. How does Gawande combine the more narrative or story-telling parts of his essay with the more informational parts? Do we get the right proportion of each?

2. Gawande explains that "figuring out what to measure" is one of the most difficult aspects of learning how well various hospitals and doctors are doing. How does that relate to the following question, which we discussed when we read Jauhar's essay? "Rewarding doctors and hospitals who produce good outcomes, and penalizing those whose outcomes are inferior, can help weed out poor care. At the same time, it can encourage caregivers to decline the sickest patients, as Jauhar points out (111). What are some possible solutions to this double-bind?"

3. If you discovered that your doctor was in the lower half of the bell curve, would you switch doctors? How much more would you be willing to pay for medical care from someone at the very top of the bell curve?

4. Universities, like hospitals and medical practitioners, are increasingly being asked to measure performance and find out how much knowledge students are actually acquiring. What might be some reasonable ways to measure or compare the performance of writing courses at different universities?