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Worth Watson's avatar

Excellent piece, TJB, which basically summarizes how all of US healthcare system is choking in the python grip of electronic medical records. I also loathe all the ways that tickbox is stealthily infiltrating our lives. These middlemen are relentless. They are everywhere. Yet, the "stakeholders" demand the metrics. To wit:

1. Why now, with all my kids' toys, do they have to recharge via USB, not a standard plug into the wall? I am not an in the basement, tinfoil antenna, bunker loving conspiracy theorist. I like straight shooting, look you in the eye, make a human connection, live life existence. No frills. No fluff. However, I now need a smarthphone/tablet/computer to charge a toy. Someone (the Internet of Things) is usurping my once direct connection. And my attention will be yet again compromised, because I had to touch the USB grantor. Not oil, not water, not your eyeballs, but your attention, is the commodity of the 21st century. And the USB is a siphon.

2. In the US, there are legion commercials for direct drug advertising to patients.Yes, legion as in Biblical locusts, but at least the locusts were kind enough to be an obvious threat. We know this happens because for every $1 Big Pharma spends on these ads, they sell $12 in pills, but I digress. What is even more insidious is how on all these commercials, the physician is never depicted talking directly to the patient. Rather, she is holding a tablet, and then smiling and showing happy news on the tablet-grrr-always on the tablet- to the patient. You can't shake my hand and communicate without an intermediary. The intervention is the tickbox, and it is pernicious. Ticked off about the tickbox.

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Vanechka's avatar

Brilliant piece, Tom! Tickboxes together with the tyranny of numbers are the worst combo you can imagine. And it's sad they are everywhere - from corporate bureaucracy to personal development. From what I experienced, they are often a result of either 1) pseudo optimisation 2) lazy automation 3) strict regulations. To me, only the latter makes sense. In some areas of our life, however, protocols are helpful (or even necessary) but, as you wrote, they are often perceived not as guidance but as ground-truth and the thing that was designed to help turns against us. Sadly, people think that outsourcing thinking to a to-do list is enough to get things done and the beauty of winging and spontaneity gets lost in endless rows and columns of tickboxes.

Luckily for me, I'm free of tickboxes on my daily job. We are pretty flexible in terms of the frameworks we use and stuff. There are some tasks that require doing things step by step and checking some crucial (scientifically) metrics but there's always room for discussion.

I'd say what's bad is "tickbox-driven" thinking, but "tickbox-informed" isn't. Human memory is imperfect and well-designed protocols can save one a lot of mental energy.

Cheers

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