Medical Malpractice and Its Reading Instruction Analogy
by Dr. Patrick Groff
NRRF Board Member & Senior Advisor
Dr. Patrick Groff, Professor of Education Emeritus San Diego State University, has published over 325 books, monographs, and journal articles and is a nationally known expert in the field of reading instruction.
The deplorable condition of much modern-day reading instruction in our schools can be illustrated through a fable about a phantasmagorical form of medical practice. This fictitious tale is about an imaginary national health care system, membership in which is compulsory to all citizens. The operations of this fanciful health care operation are controlled by government bureaucrats, who at one point may have been practicing physicians, but in their present positions devote themselves entirely to executive duties.
The medicocrats in this conjured medical system preside over the activities of two types of doctors of medicine. Category A of these invented practitioners are garden variety doctors to whom all sick people are required to consult first. This group of doctors is permitted to remain ignorant of, or to reject out of hand, large segments of the experimental evidence about physical illnesses that have been gained through medical studies.
The Md.’s in Category A defend their negative attitudes toward the empirical evidence about physical and mental unwellness on the grounds that this scientific information is a threat to their freedom, dignity, and creativeness. Having to adapt our clinical procedures so that they conform to practices indicated by the objective facts on how people get sick, and are cured of their ailments, will dehumanize us, Category A doctors protest. Nonetheless, these medical care specialists insist that they alone should determine the cost-effectiveness of the treatments they provide.
As is to be expected, a significant percentage of the patients of Category A physicians inevitably grow increasingly unhealthy as a result of the lack of scientific treatment. Consequently, after these sufferers develop symptoms that indicate their physical or mental conditions have worsened significantly, they are transferred to the care of Category B medics.
Category B doctors in this government-run mythical health delivery system are those who ground the procedures they follow more firmly on the results of experimental investigations into the effective prevention and amelioration of human disease. Nonetheless, the physical and mental well-being of a considerable number of the patients sent to them by Category A physicians already have deteriorated so badly that success in efforts to treat them is frustrated. So much so, that Category B therapeutical service generally is not very effective in curing nor otherwise rectifying the advanced stages of ill-health that patients now exhibit.
Although treatment for illness by Category B doctors is based more securely on empirical medical data than by Category A medicine, the diseases of many of the people treated at this stage of their disabilities have developed resistance to all forms of medical management, even that of the scientific variety. However, this state of affairs is of no consequence to the officials of this governmental health service agency.
Their responsibility for the outcome of its operations is successfully avoided when they lay blame for the state of unhealthy peoples’ aggravated afflictions, by saying that patients who did not respond favorably to treatment by either category of doctors’ care were “medically disabled” before they consulted any physician.
It is announced in this regard that many of the sick people attended to have been beset from the beginning of their lives with inherited “medical disabilities.” Patients’ failure to respond suitably to the services of the medical plan is interpreted to mean these people had been beyond the help of medical intervention from the onset of their indispositions.
“It is our patients’ inherent or constitutional defects that account for their becoming and staying ill,” the bureaucrats of this system for medical care arrangement announce. “Their deteriorating physical or psychological conditions are not due to the misconduct or malpractice of our doctors.” Through this means, a shift in blame for the lack of improvement in sick people is made from medical practitioners to their patient-victims.
This is an obviously capricious account of an outrageous, and therefore intolerable form of medical practice and its administration. It could not actually exist, since people seeking physicians’ help have recourse through the courts for financial recompense for medical malpractice when it occurs.
Nonetheless, the fictive tale does illustrate by analogy what medical practice would resemble if it were conducted in the same manner as is often the case at present with reading instruction in our public schools. The general outline of this imaginary story about medical deportment bears a haunting similarity to what usually transpires at present under the name of reading teaching, diagnosis of children’s reading disabilities, and measurement of their reading skills. The way these educational exercises are carried out bears a chilling resemblance to the account given here about medical practice gone wrong in a repugnant, dangerous, and outlandish manner.
Just as patients in the fictitious health care system are first treated, students in our public schools often are subjected to scientifically unverified reading pedagogy at the time they enter school. Only after students fail in their attempts to learn to read are they provided remedial teaching or assigned to special education classes. Here they are given more of the kind of instruction that experimental research indicates they should have been offered in the first place.
However, after suffering, early on, the trauma that is associated with failure to acquire reading skills, the remedial reading student typically profits little from this corrective tuition. Remedial reading programs have a deplorably low rate of success in repairing the emotional damage on learners who have undergone the injuries inflicted by unproductive beginning reading instruction.
At present, the disappointing record of efforts to remediate reading disability in children often leads to the relocation of the onus of blame for failure to learn to read, from those who manage reading instruction programs, onto the student-victims of their malpractice. Underachievers in reading are as vulnerable in this regard as were the patients so exploited in the imaginary health care service described above.
Retarded readers are said to have inherited “learning disabilities” or “dyslexia,” caused by neurological dysfunctions which teachers have no means to control or ameliorate. A glitch in the learners’ genes, rather than in the teaching system, now becomes the villain in cases of reading disablement among students.
By their widespread adoption of empirically unverified approaches to reading development, the public schools now stand rightly accused of dereliction of their fundamental responsibility to select and implement the most effective reading instruction methodology that experimental research studies can identify.
It is encouraging to find that recent events in California suggest that when government schools violate this trust, appeals to state legislatures to remind them of their duty can be successfully carried out. In 1995, it was revealed that California students had become the least capable readers in the nation. In the wake of this reading instruction disaster, the California legislature passed laws mandating the elimination of reading teaching that does not conform to empirical evidence. These reading laws require that public schools in California develop students’ reading skills in a direct, systematic, intensive comprehensive, and early manner.
The public long has been warned that it must take responsibility to make sure it receives the best possible medical care. It now is just as necessary that the people devote the same efforts on behalf of children’s most vital school accomplishment, learning to read. Citizens who observe delinquency in the schools to that effect are advised to contact their state legislators, and request public hearings on the issue.