Does the U.S. Need an Agricultural Extension Service for Education?

Back in December, the New Yorker published a really great article by Atul Gawande on reforming the health care system and reigning in health care cost growth over time. Gawande drew lessons from the activities of the USDA’s Agricultural Extension Service in the early 1900s, which, in combination with a variety of other relatively small-bore initiatives, succeeded in transforming American agriculture to be much more productive–paving the way for further economic growth.  Even though the article’s been out there a while, I’m posting about it now, because I think it has tremendous relevance to our current debates about education reform that has been under-recognized and discussed. Key grafs:

There are, in human affairs, two kinds of problems: those which are amenable to a technical solution and those which are not. Universal health-care coverage belongs to the first category: you can pick one of several possible solutions, pass a bill, and (allowing for some tinkering around the edges) it will happen. Problems of the second kind, by contrast, are never solved, exactly; they are managed. Reforming the agricultural system so that it serves the country’s needs has been a process, involving millions of farmers pursuing their individual interests. This could not happen by fiat. There was no one-time fix. The same goes for reforming the health-care system so that it serves the country’s needs. No nation has escaped the cost problem: the expenditure curves have outpaced inflation around the world. Nobody has found a master switch that you can flip to make the problem go away. If we want to start solving it, we first need to recognize that there is no technical solution.

Much like farming, medicine involves hundreds of thousands of local entities across the country—hospitals, clinics, pharmacies, home-health agencies, drug and device suppliers. They provide complex services for the thousands of diseases, conditions, and injuries that afflict us. They want to provide good care, but they also measure their success by the amount of revenue they take in, and, as each pursues its individual interests, the net result has been disastrous. Our fee-for-service system, doling out separate payments for everything and everyone involved in a patient’s care, has all the wrong incentives: it rewards doing more over doing right, it increases paperwork and the duplication of efforts, and it discourages clinicians from working together for the best possible results. Knowledge diffuses too slowly. Our information systems are primitive. The malpractice system is wasteful and counterproductive. And the best way to fix all this is—well, plenty of people have plenty of ideas. It’s just that nobody knows for sure.

A few of these issues are unique to health care, but most could also be said about our education system. Generating improvement in educational outcomes requires changing the behavior of thousands of local entities that provide complex services. Knowledge about effective practices diffuses too slowly. Information and other critical systems are primitive. Education spending, like health spending, has  increased dramatically in recent decades, and given current state and federal fiscal challenges, and the fact that we no longer have rising property values fueling predictable increases in state and local property tax revenues, education, like health, is going to need to identify ways to become more productive with relatively flat resources. Perhaps most important, while some of our educational challenges are amenable to technical solutions, many are not.

Some further thoughts on this:

First, the Agricultural Extension Service model that Gawande is talking about here is worth looking at as a potential model for efforts to improve education. One of the things we’ve learned from the past half century’s experience in education reform is that neither input regulation nor incentives/accountability focused on outcomes are, on their own, sufficient to get results in many of the biggest problems facing our education system. We need something more complex that combines both better incentives (as Gawande notes the agricultural improvements of the early 1900s also required) and new strategies that actually help and persuade practitioners to change their behavior in ways that produce greater results. Secretary Duncan has talked about creating a more collaborative partnership between the feds and state and local school districts to improve achievement–the history of the agricultural extension service may offer some useful models here.

Second, it’s worth noting that the dramatic improvements in agricultural productivity in the early 1900s did not come without a significant degree of displacement and pain for some producers. People in education tend to want to be nice and look for solutions that don’t require anyone to suffer–but getting to a much better system is going to require changes that do threaten the interests, privileges and prerogatives of some current participants in the system.

Third, I think it’s important to recognize that there’s actually tremendous similarity between some of the challenges facing health care right now, and those facing education. Both the health and education sectors face shared challenges of reigning in costs and persuading practitioners to change behavior and implement effective practices. In both sectors, change cannot be imposed by fiat but requires using rather oblique policy levers to shift the behavior of thousands of local providers. And both sectors deliver complex services to people–students and patients–who ultimately need to participate themselves in producing desirable health and education outcomes. There are interesting things going on in both the education and health sectors that the other sector could learn from, but policy wonks and practitioners in both sectors are often unaware of what’s going on in the other. Health and education policymaking, in particular, would benefit from much more robust and deep exchange of ideas, lessons, and best practices across the two sectors.

Finally, I think the notion that certain types of challenges are never solved, but managed in ways that generate ongoing improvement, is particularly important to keep in mind in thinking about education reform.

Of late, some folks in the education policy space have been grappling with the question of “what next”–what will be the driving ideas and focuses in education policy in a post-NCLB world. To date, I haven’t heard a lot of compelling answers there. But I think the ideas in Gawande’s article provide a useful starting point for thinking about some of what the “what next” should look like.

–by Sara Mead

5 Replies to “Does the U.S. Need an Agricultural Extension Service for Education?”

  1. It’s not a new idea. I wrote a paper about that with Marsha Silverberg back in 1998. Marsha is now the acting director of knowledge utilization for the U.S. Department of Ed/Institute of Education Sciences.

    http://bit.ly/9gIMNy

  2. Sarah,

    Agricultural history is not your field nor Gwande’s, but it used to be mine. You correctely write “it’s worth noting that the dramatic improvements in agricultural productivity in the early 1900s did not come without a significant degree of displacement and pain for some producers.” Yeah that’s an understatement. Think of the Okie movement. Think of the Great Migration. The problem, Gwande’s ill-informed metaphor notwithstanding, was not ignorance of the farmers. It was the complex systems of social and economic and political oppression. The so-called experts in the Ag Dept just thought they understood the problem. Were there isolated successes from respectful Ag experts like the one featured by Gwande? Yeah, but they weren’t the solution to the fundamental problem. And those experts sure haven’t dealt with the environmental havoc and unintended consequences of their efforts here or abroad.

    But youre completely off base in the following. “People in education tend to want to be nice and look for solutions that don’t require anyone to suffer–but getting to a much better system is going to require changes that do threaten the interests, privileges and prerogatives of some current participants in the system.” Oh come on, the generational poverty produced by horrific exploitation that Gwande misdiagnosed did not solve the problem. Society as a whole evolved.

    Destroying the teaching profession isn’t going to benefit students.

    But the following is the key because it demonstrates a fundamental misunderstanding of the role of data when you write “Third, I think it’s important to recognize that there’s actually tremendous similarity between some of the challenges facing health care right now, and those facing education.” As Gwande has written, data-DRIVEN accountability has consistently failed in health and it will continue to fail. The key must be data–INFORMED accountability and evidence-based decision-making. And the key to that is respecting the professional autonomy of doctors. Its so easy to disrespect teachers that it seems plausible that you can deliever the ultimate insult to our profession – the idea that you can cut up teaching and learning into measurable pieces, and subordinate the professional autonomy of teachers to theories and ill-informed metaphors. (and by the way, Groopman and others are even more sobering in the role of data, saying the checklists only work in certain situations.)

    These data-DRIVEN reforms are based on theories and metaphors. Spend some time in urban schools and then look at the evidence. Look at the social science.

    You write “Third, I think it’s important to recognize that there’s actually tremendous similarity between some of the challenges facing health care right now, and those facing education.”

    As Gwande implies, health reformers are lucky that the idea of top down mandates on doctors is a nonstarter. It forces conversations.
    When I’m introduced as Dr. Thompson, historian, I get respect. Mr. Thompson, the teacher, is just a pawn in your game.

    You write about “changing the behavior of thousands of local entities…” I have a huge amount of respect for your knowledge IN YOUR FIELD (just like I have a huge amount of respect for the Ag Agents who listened, learned, and actually helped especially in places like Iowa). But how much real world knowledge do you and your fellow “reformers” have about the full range of those “local entities” and in areas outside your field? I thought i had a lot of answers regarding urban education before I spent 18 years in the urban classroom.

    But before you think you, or your school or thought, or any social engineers think they have the answer, first think of the Ag Agents and the first generation data-driven health reformers who didn’t have a clue about the limits of their knowledge.

    A little knowledge is a dangerous thing. Stop playing dice with the lives of teachers and our students. Show a little humility.

  3. “People in education tend to want to be nice and look for solutions that don’t require anyone to suffer–but getting to a much better system is going to require changes that do threaten the interests, privileges and prerogatives of some current participants in the system.” My guess is that neither you nor any of the new venture capital/CEO reformers are willing to volunteer to be the ones that suffer. Or anyone in your families or in your friendship network.

    Rather than reigning in costs, we should be investing MORE in schools. Isn;t it ironic that the people supporting charter schools call for public schools to be more efficient, yet have their hands out asking for millions of dollars with little evidence of success except for a good PR campaign.

    Im completing a study of high performing schools and districts and each of them have invested heavily in new technology and data systems. These things are expensive. Yet people keep complaining that per pupil expenditures have increased. Well duh–the way we do education now is vastly more expensive now. We did not have computers, white boards, data systems, etc. These are costly, but can make educators more effective. Where, exactly, are the efficiencies supposed to come from? Im sure you ight suggest wiping out pensions.

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