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Tomaino Arm Care Network

Dr. Tomaino's Blog

Intangibles are Immeasurable

April 24th, 2011
On a plane ride home yesterday from a “spring break” vacation with my family, I read, on B7 of the Wall Street Journal, a most interesting article entitled: “In a Data-heavy Society, being defined by the Numbers.”

The gist of the article, as you might expect, was that numbers may be over-rated. How one arrives at a numerical rating, and whether a higher number reflects superlative value is, indeed, worth thinking about.


Whether the issue is your child’s class rank in high school, a college’s ranking as they assess the best school for them, the NCAA rank of your favorite college football or basketball team……….whatever--we are all admittedly preoccupied a bit with “Numbers” as a proxy for what may be better, or the best! Of course, we’ve all been disappointed by underperformance despite an otherwise attractive numerical rating.


Indeed, as a singular metric, numbers may not necessarily differentiate relevant from irrelevant, satisfied from dissatisfied, or excellent from mediocrity. Nevertheless, we all may from time to time be prone to a sort of deferential acknowledgement of a higher number, as if it meant something!
For example, I recently heard a radio advertisement for an Orthopaedic practice that proudly extolled a #1 ranking in NIH funding for Research —as part of a broader solicitation for business—and pondered as to whether that statistic mattered to most potential patients with musculoskeletal pain.

Notwithstanding the impressiveness of the numerical ranking—being awarded NIH dollars is competitive—the true litmus test of relevance to the patient might never be attained simply because of the NIH research ranking alone-- absent successful commercialization of experimental findings along with, not only efficacious outcomes, but also affordability. Ofcourse, marketing gurus probably figured that #1 was impressive enough to tout.


I, on the other hand, would be more impressed by the family physician who never performed research herself, but conscientiously kept abreast of the most current literature, assessing the results of others’ research, and , in an unbiased manner, applying her new knowledge when it served her patient most effectively.


Numbers, themselves are frequently “marketed” in our society, despite the fact that they have no inherent meaning. Numbers and rankings are everywhere—and I’m not just talking about Facebook friends and Twitter followers. We use standardized test scores to evaluate teachers, students, doctors-- and University hospitals take pride in their annual rankings by US News and World Report—as if ranking, alone, is a proxy for customer satisfaction with their offering. To a certain extent, we might all agree that we need to find ways to measure and evaluate people and products in as objective a way as possible—especially in health care.



But isn’t it our “human condition” -- our soul, compassion, conscience and ability to navigate what is not black and white-- which more frequently differentiates our offering? As far as I know, there is no effective way to measure intangibles like a smile, hopefulness, compassion , and kindness.


As the article I mentioned above suggested--numbers make the intangibles tangible. They give the illusion of control. Like one’s preoccupation with horsepower when shopping for a new car, we may be inclined to quantify everything, to ground a decision in fact, instead of asking whether a particular variable matters.


When I started Tomaino Orthopaedic Care nearly 3 years ago I referenced a book by Seth Godin in one of my early blogs entitled “Small is the New Big.” His point was that size (the number) may be a metric which is deceiving—though used all too often by businesses as a basis for marketing a competitive advantage.
What I have found as a Physician is that all those “Numbers” may result in us losing sight of why we are really doing what we’re doing. Again—as part of the same radio message I referred to earlier, a local practice’s advertisement claimed that their practice was 6x the size of any other local practice—40 doctors—after which I thought, “ isn’t a patient’s satisfaction with their visit based, more likely than not, on an interaction with a single physician—as opposed to the shear size and scale of the office?”



If you need a shoulder replacement, a rotator cuff repair, care for your sprained or broken wrist, or a carpal tunnel release, is the size metric—the numerical scale—really relevant? Our reliance on, and overwhelming trust in numbers reflects our discomfort with, and arguably our mistrust of, the immeasurable—intangibles such as experience, accountability, expertise, wisdom, and authenticity.



Interestingly, Seth Godin’s suggestion that “Small is the New Big” suggests, in fact, that it is the immeasurable that may differentiate the offering. The relevant metric, he would argue-- and I have experienced this throughout my career at two University-based practices and now at Tomaino Orthopaedic Care—is neither size nor scale dependent.



Although the intangibles are immeasurable, so too might the numbers be misleading.

*POST EDITED BY DR. TOMAINO.


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