The chapter listed four ways that people react to a measurement that affects them: doing what the measurer wanted; doing something slightly different that is measured well; lying; and avoiding being measured. Note which type of behavior you think is being exhibited in each of 1 to 4 below. Also note if there are unintended consequences.

Some hospitals use “patient satisfaction surveys” to measure whether the patients treated by particular doctors or departments are happy with how the hospitals treated them. The goals of these measurements are to help identify both problems and good practices, and to make the doctors conscious of the need to consider how patients feel about their care. Some reactions are:

1. Some doctors began avoiding dealing with psychiatric patients, who are often more difficult to please 2. Some doctors began spending more time with patients, listening more carefully to their complaints 3. Some doctors began prescribing unnecessary tests, because patients are happier when they feel the doctor has “done something”

4. Some doctors made a point of asking patients who seemed happy with their care to fill out the surveys, but did not ask less happy patients to fill out the surveys.