Virginia Postrel is blogging a very polite discussion about a New Yorker articles's comparison between two Cystic Fibrosis clinics. One critic is concerned that the article unfairly assumes that the between-clinic difference in patient outcomes is due to physician performance. His concern is that this will create all manner of ill-will between patients and doctors, impairing the patients' treatment. (I am trying to summarize without grossly mischaracterizing the debate. And I'll bring this around to dieting in a moment.)
One of the causes of different outcomes in CF treatment is patient compliance. The critic's position is that the study treats patient compliance as an attribute of the clinic's performance. He is a CF patient, and he probably views compliance as something that is his responsibility, not his doctor's. When choosing a clinic or a doctor, he is planning to comply with the program, so the clinic's or doctor's compliance experience does not enter into his choice.
However, a manager of a CF clinic might look at it differently. Patient compliance levels are a big contributor to his clinic's performance, and if there is a statistically significant difference between his clinic and another, or between the individual doctors in the clinic, this is something he might want to examine closely to see if there is room for improvement.
Even a patient might want to look at compliance levels because they are presumably affected by the clinic's capabilities to make it easier for patients to follow their treatment plan. As a patient, you might want to pick a clinic that makes this easier for you.
A similar calculus applies to picking a diet. The big national studies of the effectiveness of different diets include the effects of participants who quit or who fail to follow the diet. When picking a diet plan to follow, however, I'm tempted to disregard this part of the study. After all, I'm planning to follow the diet.
I've been reading several books on dieting, in part just to keep my mind focussed on the topic, and I'm starting to think that maybe I should be thinking more about a diet plan that's easy to follow.
