Getting to 5% Variance

August 20, 2012
I've always thought there was too much unexplained variation in the services provided to consumers by most health and human service programs. But, the pushback to providing services that are standardized around current scientific findings is that "complex" consumers require complex interventions that defy such standardization. I hear the phrase "cookie cutter" a lot.

Then, I read two articles that really captured the heart of this debate. The first was Big Med, written for The New Yorker by Harvard professor of public health, Atul Gawande, M.D. In the article, the director of performance improvement at . . .