No Replication of Contextual Errors in Child Welfare

What we have here is a great idea gone bad...

Researcher uses 'mystery patients' to uncover doctors' errors

The elderly man was emaciated and hospital physicians were running a series of tests for cancer, a common cause of weight loss in older patients. Dr. Saul Weiner suspected something else might be going on.

"Where are you living?" he remembers inquiring. "I move around a lot," the haggard man responded. Weiner then asked if his patient was eating regularly. Sometimes, but not every day, the man admitted.

A diagnosis snapped into focus: The disheveled patient was homeless and starving. Weiner canceled the tests and called in a social worker. The experience at a Chicago hospital several years ago inspired Weiner to study what he calls "contextual errors": the failure by doctors to consider an individual's social or economic circumstances when diagnosing illness or prescribing treatment...more

I come in defense of the physicians.

The study is suppose to identify contextual errors. What the study actually identifies is that the intake workers of the hospital, typically social workers, are not doing very good jobs.

Someone is going to have to explain to me why a person, who has dedicated at least 10 years of his or her life mastering the field of medicine, must be reduced to practicing pseudo-empirical science such as social work or psychology?

Instead, why not restructure the administration instead of the practice of the doctor.

Here is a perfect example of what I am speaking about: child welfare.

In child welfare, the child abuse and neglect investigation, there could never, ever, ever be a replication of this study. There will never be the identification of contextual errors in child protective services.

In child protective services (CPS), you have social workers doing the decision making of doctors, judges and policy makers.

A CPS worker can, on the spot, make medical diagnoses, without any medical training and decide to immediately remove a child.

A foster care worker can, on the spot, make an Axis III diagnosis and refer for anti-psychotic medication. The doctor will write the script by taking the decision of the foster care worker without question.

There may never be a replication of a study of this kind, but there exists a myriad of publications on what may be called contextual errors in child welfare, but I simply prefer to use the term fraud.

Every foster child is a mystery child under the Freedom of Information Act.

It's time to restructure the entire Administration on Children and Families.

Try using a "mystery patient" in foster care...anyone brave enough to subject your own child to the foster care system if it is so great?

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