Saturday, March 03, 2007

John Taylor's "No Dentist Left Behind"

On my last post, M wanted to share the following essay by John Taylor, a retired school superintendent in South Carolina. I loved it, but I suspect that many of my non-teacher readers will hate it. In any case, I thought it was too good to leave buried as the 4oth comment for one of my posts. Taylor originally wrote the essay a number of years ago in reaction to an accountability program in South Carolina. It was resurrected after No Child Left Behind was passed, and it has made the rounds through email and other Internet sources. In any case, here it is.

No Dentist Left Behind My dentist is great! He sends me reminders so I don't forget checkups He uses the latest techniques based on research. He never hurts me, and I've got all my teeth. When I ran into him the other day, I was eager to see if he'd heard about the new state program. I knew he'd think it was great.

"Did you hear about the new state program to measure effectiveness of dentists with their young patients?" I said.

"No," he said. He didn't seem too thrilled. "How will they do that?"

"It's quite simple," I said. "They will just count the number of cavities each patient has at age 10, 14, and 18 and average that to determine a dentist's rating. Dentists will be rated as excellent, good, average, below average, and unsatisfactory. That way parents will know which are the best dentists. The plan will also encourage the less effective dentists to get better," I said. "Poor dentists who don't improve could lose their licenses to practice."

"That's terrible," he said.

"What? That's not a good attitude," I said. "Don't you think we should try to improve children's dental health in this state?"

"Sure I do," he said, "but that's not a fair way to determine who is practicing good dentistry."

"Why not?" I said. "It makes perfect sense to me."

"Well, it's so obvious," he said. "Don't you see that dentists don't all work with the same clientele, and that much depends on things we can't control? For example, I work in a rural area with a high percentage of patients from deprived homes, while some of my colleagues work in upper middle-class neighborhoods. Many of the parents I work with don't bring their children to see me until there is some kind of problem, and I don't get to do much preventive work. Also, many of the parents I serve let their kids eat way too much candy from an early age, unlike more educated parents who understand the relationship between sugar and decay. To top it all off, so many of my clients have well water which is untreated and has no fluoride in it. Do you have any idea how much difference early use of fluoride can make?"

"It sounds like you're making excuses," I said. "I can't believe that you, my dentist, would be so defensive. After all, you do a great job, and you needn't fear a little accountability."

"I am not being defensive!" he said. "My best patients are as good as anyone's, my work is as good as anyone's, but my average cavity count is going to be higher than a lot of other dentists because I chose to work where I am needed most."

"Don't' get touchy," I said.

"Touchy?" he said. His face had turned red, and from the way he was clenching and unclenching his jaws, I was afraid he was going to damage his teeth. "Try furious! In a system like this, I will end up being rated average, below average, or worse. The few educated patients I have who see these ratings may believe this so-called rating is an actual measure of my ability and proficiency as a dentist. They may leave me, and I'll be left with only the most needy patients. And my cavity average score will get even worse. On top of that, how will I attract good dental hygienists and other excellent dentists to my practice if it is labeled below average?"

"I think you are overreacting," I said. "'Complaining, excuse-making and stonewalling won't improve dental health'... I am quoting from a leading member of the DOC," I noted.

"What's the DOC?" he asked. "It's the Dental Oversight Committee," I said, "a group made up of mostly lay persons to make sure dentistry in this state gets improved"

"Spare me," he said, "I can't believe this. Reasonable people won't buy it," he said hopefully.

The program sounded reasonable to me, so I asked, "How else would you measure good dentistry?" "Come watch me work," he said. "Observe my processes."

"That's too complicated, expensive and time-consuming," I said. "Cavities are the bottom line, and you can't argue with the bottom line. It's an absolute measure."

"That's what I'm afraid my parents and prospective patients will think This can't be happening," he said despairingly.

"Now, now," I said, "don't despair. The state will help you some."

"How?" he asked.

"If you receive a poor rating, they'll send a dentist who is rated excellent to help straighten you out," I said brightly.

"You mean," he said, "they'll send a dentist with a wealthy clientele to show me how to work on severe juvenile dental problems with which I have probably had much more experience? BIG HELP!"

"There you go again," I said. "You aren't acting professionally at all."

"You don't get it," he said. "Doing this would be like grading schools and teachers on an average score made on a test of children's progress with no regard to influences outside the school, the home, the community served and stuff like that. Why would they do something so unfair to dentists? No one would ever think of doing that to schools."

I just shook my head sadly, but he had brightened. "I'm going to write my representatives and senators," he said. "I'll use the school analogy. Surely they will see the point." He walked off with that look of hope mixed with fear and suppressed anger that I, a teacher, see in the mirror so often lately.

26 Comments:

Blogger Liz said...

Liz from I Speak of Dreams.

Whitney Tilson rewrote the football version to be the way Tilson perceives NCLB




No Child Left Behind: The Football Version

1. All teams must play hard and do their best. If a team is poorly managed and disorganized, it will be put on probation until it improves, and the coaches will be held accountable. The children and their parents will not be blamed for the failure of the coaches.

2. All kids will be expected to play. Obviously, some kids will play with more skill than others, but all kids will be expected to work hard and perform at a proficient level. Some kids may need to work extra hours to achieve proficiency. The coaches will be expected to put in those extra hours with the kids to ensure their success.

3. Coaches will not focus their resources solely on the handful of players who demonstrate unusual proficiency at an early age. Coaches will be held accountable for the success of EVERY player.

4. Games will be played year round, and statistics will be collected, analyzed and widely disseminated frequently.

5. This will create a New Age of sports where every kid learns the necessary tools to succeed.

Just because some children get ahead, it's not acceptable that many children get left behind.

3/03/2007 4:27 PM  
Blogger the anonymous teacher said...

It seems as if she's picked and chosen which parts of the law to include...possibly I'm also a little biased against NCLB because I've seen the negative effects...

I'm able to admit my bias, though.

3/03/2007 4:35 PM  
Blogger Bardiac said...

Brilliant!

3/03/2007 9:19 PM  
Blogger M said...

hehe, I liked John Taylor's analogy for its basic message and that is - there's a whole bunch of stuff that is going on in the classroom and in education that results and stats simply cannot, nor will ever explain properly. There really IS a bigger picture and not realising that is way too simplistic to take seriously!

3/03/2007 11:16 PM  
Blogger Dennis Fermoyle said...

Amy H. made the following comment over at my last post, and I've decided to bring it over here:
______________
m mentions "assumption versus reality". Sometimes it's interesting to know just what is being considered as this "reality" of testing data.

Way back up in the original comments on (the previous) post, Rory noted this about Dennis's school:

"Your schools kids do do pretty well in writing on their 10th grade BST test.

The worst results are on the 11th grade math test."

Being from Minnesota, I can tell you that nearly all schools in the state had results that were awful last year for the 11th grade math test.

Are all of Minnesota's kids bad at math by 11th grade? Would this "data" cause someone to not choose to move to a certain area or school district in Minnesota if they had high school-aged kids?

Reality: The 11th grade math test meant absolutely nothing to the kids. The 10th grade reading and writing tests were "graduation tests" - kids have to pass them to graduate. Last year's 11th grade math test was a "school test". Guess what? A lot of kids didn't try really hard on that test - it didn't affect them personally. A lot of kids finished in 10 minutes and slept / read / did something they found more important than proving their school isn't leaving anyone behind. There's no disclaimer with the "data" to let the reader know about that reality.

I'm OK with "accountability", but NCLB is done so differently even from state-to-state, I'm not certain it really shows much sometimes.
_________________

I think Amy H. makes great points, and I definitely agree with what she's saying. In fairness to NCLB (after all, this is a "fair and balanced" blog) beginning next year, those eleventh grade math tests will count towards graduation. Again, math is not my subject, but that's my understanding.

There is a lot I don't like about NCLB, especially the "failing schools" tag, but I do have to admit that our miserable results on that math test have our school working overtime to improve in that area. EVERYBODY is concerned about it, and that's a good thing. I'd love to be able to say that if there was no NCLB, and our kids were doing poorly in math, that we'd be just as concerned and working just as hard to fix the problem, but that wouldn't be honest.

3/04/2007 2:56 AM  
Blogger KDeRosa said...

This analogy needs some revisions to make it accurate.

First, educators do not use the “latest techniques based on research.”

And, the cavity analogy is off. To make the analogy more accurate it should be changed to "They will just test the quality of each filling each patient has at age 10, 14, and 18 to determine a dental practice’s rating. Dental practices will be rated as meeting expectations or not meeting expectations depending upon whether the number of “proficient” fillings measured. Some may use this data to judge which dental practices are the best, but that would be an inappropriate use of the data and not a requirement under the law. Dental practices that do not meet expectations and who don’t improve may be targeted for restructuring which may result in the closing of the practice. Individual dentists working in these failed practices may lose their jobs and may need to find new jobs, but their licenses are not in jeopardy under the law.

Some dental practices are located in areas where children are more susceptible to cavities due to external forces, such as poor parental guidance and diet. This makes it more difficult to practice dentistry in these areas. But, we know that there exist high performing dental practices that work in similar areas that manage to meet quality expectations for the filling of cavities under similar conditions and with the same funding levels. Therefore, we know that requiring dental practices to meet expectations in these areas, while difficult, is within their ability if these practices use research-based practices.

Next let’s revise the dentist’s statement to see if it still makes sense:

"I am not being defensive!" he said. "My best patients are as good as anyone's, my work is as good as anyone's, but the quality of my fillings is going to be lower because my kids have more cavities which are more difficult to fill than a lot of other dentists because I chose to work where I am needed most." [This may become an issue when the AYP ratchets up to the 90%+ level, but it is not an issue now with proficiency levels being so low in most states.]

Then we have this line: The program sounded reasonable to me, so I asked, "How else would you measure good dentistry?" "Come watch me work," he said. "Observe my processes." To make this analogy like teaching, the processes we’d observer would consist of the dentist fixing cavities by attaching one end of the string to the tooth and the other end to a doorknob, and then slamming the door.

3/04/2007 6:55 AM  
Blogger Roger Sweeny said...

The analogy would be more compelling if kids were legally required to be in a dentist's office 6 1/2 hours a day, 180 days a year, for 12 years.

3/04/2007 10:22 AM  
Blogger Dennis Fermoyle said...

KDerosa, I'd almost have been disappointed if you hadn't commented on this. I have to admit that your last line cracked me up.

Roger Sweeny, welcome to this blog. I'm speaking only for myself here, but I'm actually with you on this one. If kids don't want to be in my class--whether it's their own attitude or simply a reflection of their parents', I'd just as soon not have them there, either.

3/04/2007 1:05 PM  
Blogger Tracy said...

Well if you're going to publish M's comment, I'll add my own reply in this thread as well.

M - let's take your dentist/customer conversation a different way.

"Don't you see that dentists don't all work with the same clientele, and that much depends on things we can't control? For example, I work in a rural area with a high percentage of patients from deprived homes, while some of my colleagues work in upper middle-class neighborhoods. Many of the parents I work with don't bring their children to see me until there is some kind of problem, and I don't get to do much preventive work. Also, many of the parents I serve let their kids eat way too much candy from an early age, unlike more educated parents who understand the relationship between sugar and decay. To top it all off, so many of my clients have well water which is untreated and has no fluoride in it. Do you have any idea how much difference early use of fluoride can make?"

"It sounds like you're making excuses," I said. "I'm surprised that you're ignoring dental methods that have made great improvements in the outcomes of even patients from poor backgrounds. P.S. 161 from Brooklyn is also working with a poor, low-income group in a rural area and he's getting cavity rates that are below the state average. And Portland Elementary is also getting great results. Why don't you go and study these successful dentists methods for reducing cavities in low-income areas, and implement them in your practice?"

"Of course" I added, "I don't mind if you use a different method, as long as it's getting results like P.S. 161 or Portland Elementary."

3/04/2007 2:19 PM  
Blogger Dennis Fermoyle said...

Hi Tracy,

I like M's (Taylor's) analogy better than yours, but be my guest. That's what we're here for!

3/04/2007 2:29 PM  
Anonymous Anonymous said...

Your analogy would also work better if I could decide which teacher or school I wanted for my kid. If my dentist isn't working for me, I pick up and choose another practice.

3/04/2007 5:42 PM  
Blogger Tracy said...

I like M's (Taylor's) analogy better than yours, but be my guest. That's what we're here for!

I think I am failing to understand you. Do you really prefer a analogy which implies that teachers can't improve the education of low-income kids to one that argues that they can (with links)? That doesn't make sense.

Why do you like M's analogy?

3/04/2007 6:49 PM  
Blogger Dennis Fermoyle said...

Tracy, I apologize. Yesterday, I clicked on your name for your profile, but then I totally zoned out on the fact that you had links to your examples. I have a theory that left-handers tend to be absent-minded, and I keep proving it to myself everyday. It's 5:15 in the morning here, I just got back from my jog, and I've got to get ready for school, so I've only glanced at a couple of the links. They do look impressive, and I will get back to them later in the day. Did you see my post on DI a while back? Thanks again for your contribution!

3/05/2007 3:27 AM  
Blogger KDeRosa said...

I think Eduwonk has the best comment on this topic:

These silly "No Child Left Behind the Football Version" or "No Child Left Behind the Dentist Version" keep making the rounds on the web. They're inadvertently a pretty scathing indictment not of No Child but rather the mindset that led to its necessity and enactment.


ANd, I don't think he saw the arguments being touted by teachers in Dennis' previous post which drive this point home very strongly.

3/05/2007 6:34 AM  
Blogger M said...

I don't think that anyone is saying that education is perfect and needs no revising. Just that there are a lot of simplistic arguments which fail to take into account that there's a lot more going on than people think.

I mean, look at any sum. =5 means nothing on its own. It's more than just 4+1 (it might be 3+2 or 25/5 or any other multitude of complex sums) and, not only that, there is a whole bunch going on in the theory of each and every sum to get the answer. =5 means absolutely nothing unless you take the whole sum, history, context and everything else into account.

3/05/2007 12:21 PM  
Blogger Tracy said...

Dennis Fermoyle - apology accepted. I thought there must be something weird going on. (Incidentally I'm left-handed and a bit absent-minded too).

3/05/2007 12:41 PM  
Blogger Dennis Fermoyle said...

Tracy (or should I say Lefty?),

I checked out those links and I got this out of it. (I'm doing this, because I'm kind of like that character played by Denzel Washington in the movie "Philadelphia"--you've got to tell it to me like I'm a six-year-old.) The schools you refer to are both in low income areas, they have turned to Direct Instruction, and the results have been very impressive. Right? I know that seems to speak for itself, but if you have any more info on this I'd love to hear it.

3/05/2007 4:09 PM  
Blogger Tracy said...

Umm, now it's my confession term. Actually I was lazy and tossed together the DI link and some examples of some schools with low-income areas and great test results. I haven't actually checked the methods those schools use.

It was a quick way of showing that better results are achievable - unlike the negative impression the Dentist story gives. I may not be a dentist, but if some dental practices are producing far better outcomes with similar patient populations than others, I think I have standing to ask why a dentist is complaining about the standards rather than learning from the successful examples.

DI has a lot of good theory behind it, and it's been thoroughly tested and improved based on that testing during development, and it's shown reliablity in testing. It's probably far more reliable to look at than any one individual school's results.

On Monday, March 12, Engelmann is going to have all the chapters of his book available at http://zigsite.com/Book_Schedule.htm for one week. I suggest you look there for more about DI and examples of schools that have been turned around.
Right now, chapters 6 and 7 are available. If you go to pages 17 to 21 of chapter 7 (at
http://zigsite.com/PDFs/FOLLOW_THROUGH/FT-Chap7.pdf
, you'll see an example of a school with a rough background that achieved a great turn-around by DI.

3/05/2007 8:15 PM  
Blogger sexy said...

一夜情聊天室,一夜情,情色聊天室,情色,美女交友,交友,AIO交友愛情館,AIO,成人交友,愛情公寓,做愛影片,做愛,性愛,微風成人區,微風成人,嘟嘟成人網,成人影片,成人,成人貼圖,18成人,成人圖片區,成人圖片,成人影城,成人小說,成人文章,成人網站,成人論壇,情色貼圖,色情貼圖,色情A片,A片,色情小說,情色小說,情色文學,寄情築園小遊戲, 情色A片,色情影片,AV女優,AV,A漫,免費A片,A片下載

情色,A片,AIO,AV,日本AV,色情A片,AV女優,A漫,免費A片,A片下載,情色A片,哈啦聊天室,UT聊天室,聊天室,豆豆聊天室,色情聊天室,尋夢園聊天室,080視訊聊天室,080聊天室,080苗栗人聊天室,免費視訊聊天,上班族聊天室,080中部人聊天室,視訊聊天室,視訊聊天,成人聊天室,一夜情聊天室,辣妹視訊,情色視訊,成人,成人影片,成人光碟,成人影城,自拍

A片,AIO,AV,日本AV,色情A片,AV女優,A漫,AIO交友愛情館,線上A片,免費A片,A片下載,情色A片,微風成人,嘟嘟成人網,成人,成人影片,成人光碟,成人影城,成人交友,愛情公寓,色情聊天室,情色貼圖,色情,色情影片,做愛,情色,哈啦聊天室,聊天室,UT聊天室,豆豆聊天室,尋夢園聊天室,080視訊聊天室,080聊天室,080苗栗人聊天室,自拍,性愛

情趣用品,情趣用品,情趣,情趣,A片,A片,情色,A片,A片,情色,情趣用品,情趣用品,A片,A片,情色,情色

情色視訊,美女視訊,辣妹視訊,視訊聊天室,視訊交友網,免費視訊聊天,視訊交友90739,視訊,免費視訊,情人視訊網,視訊辣妹,影音視訊聊天室,視訊交友,視訊聊天,免費視訊聊天室,成人視訊,UT聊天室,聊天室,豆豆聊天室,色情聊天室,尋夢園聊天室,聊天室尋夢園,080聊天室,080苗栗人聊天室,上班族聊天室,小高聊天室

3/03/2009 12:04 AM  
Blogger sam said...

It was such a good article and so much related to our directory.
Lawrenceville dentist

8/12/2010 1:08 AM  
Blogger Dylan Hall said...

Me & my neighbour were preparing to do some research about that. We got a good book on that matter from our local library and most books where not as influensive as your information. I am very glad to see such information which I was searching for a long time.

isuzu parts

1/30/2011 9:48 PM  
Anonymous Socialkik said...

Socialkik is the #1 place to buy cheap facebook fans, you can also buy twitter followers, youtube views and subscribers and google +1 votes. Try coupon code: STANDARDKIK for $10 off.

1/25/2012 12:25 AM  
Blogger davis paul said...

What a good blog you have here. Please update it more often. This topics is my interest. Thank you.

Click here

12/16/2013 11:53 PM  
Blogger Leonard spaulding said...

looks pretty good your site
UFB Underground MC Cable

12/17/2013 12:55 AM  
Blogger Leonard spaulding said...

Very interesting information! Thanks!
Click Here

12/17/2013 2:48 AM  
Blogger Phillip Irvin said...

What a good blog you have here. Please update it more often. This topics is my interest. Thank you.

Personal Injury Lawyer Providence

1/10/2014 8:50 PM  

Post a Comment

Links to this post:

Create a Link

<< Home